Objective To study the features of Kawasaki disease (KD)with liver damage and investigate the possible related factors,and to improve the understanding of liver damage in KD patients.Methods The clinical data of 75 KD patients admitted from 2008 to 2013 were collected to retrospectively analyze the clinical features of liver damage,as well as routine blood test,C-reactive protein (CRP),erythro-cyte sedimentation rate (ESR),liver function,and abdominal ultrasound.Categorical data were analyzed by chi-square test;continuous data were expressed as mean ±standard deviation;comparison between groups was made by t test and multivariate stepwise regression analy-sis.Results The incidence of abnormal alanine aminotransferase (ALT)level in 75 cases was 32%,and 79.2% of these patients had a serum ALT level of less than 200 IU/L,including 3 patients with hepatomegaly,1 patient with jaundice,and 1 patient with splenomegaly, which accounted for 12.5%,4.2%,and 4.2%,respectively,of patients with liver damage.CRP and ESR were not found to be related to liver damage (t=1.560,P=0.123;t=1.291,P=0.201).There was significant difference in platelet count between patients with liver damage and controls (t=-3.228,P=0.003).No significant difference in white blood cell (WBC)count increase was found between the liver damage group and control group,but simultaneous increase in WBC count and platelet count was significantly associated with an in-creased risk of liver damage (P<0.05).Conclusion CRP and ESR are not found to be significantly related to the development of liver damage,but there is a close relationship between liver damage and abnormal platelet count.WBC count shows a certain relationship with liv-er damage.Clinicians should pay attention to these factors and take timely measures for intervention.

Objective To investigate the influence of comprehensive psychological intervention and cognitive therapy on cognitive function in schizophrenia.Methods A total of 80 patients with schizophrenia were randomly divided into the comprehensive psychological intervention group (group A,n=40)and the cognitive therapy group (group B,n=40).Before and after 8-week treatment,the influence on cognitive function were measured with WAIS-RC,WMS,WCST and TESS were compared between two groups.Results After eight weeks,the intelligence quotient,remembrance quotient ,sustained errors and random errors in group A (110.52±18.03,110.78±1.15.42,15.48±9.82,17.46±13.28) were higher than that in group B (96.64±18.26,102.23±13.4,20.35±11.47,24.92±13.71).The difference between the two groups was found in improving cognitive function in schizophrenia patients(P＜0.05).Conclusion Cognitive therapy could improve cognitive function in schizophrenia,but comprehensive psychological intervention would do much better.

Objective To investigate the prevalence of anxiety and depression in adolescent children, and to explore influencing factors of anxiety and depression. Methods From May 2016 to September, 435 students at the age of 10~18 were randomly selected from primary school, middle school, high school in Weifang city. The Screen for Child Anxiety Related Emotional Disorders (SCARED) and Depression Self-rating Scale for Children (DSRSC) were used to evaluate the Clinical manifestation of students with anxiety and depression. A survey on the factors influencing anxiety and depression in adolescence was used to evaluate the related factors of students with anxiety and depression. Results The incidence rate of the anxious and depression of adolescent children in Weifang City was 20.6% and the average age was (12.38±3.58). The occurrence rate of anxious and depression was higher in girls than in boys (26.5%vs. 15.7%, P<0.05). Personal unhealthy (OR=0.387, P=0.001), lack of parental accompaniment (OR=0.671, P=0.020), low parental educational levels(OR father=0.338, P=0.001; OR mather=0.262, P=0.001), poor parental relationship (OR=1.049, P=0.008), bad parenting styles (OR=0.471, P=0.016) were risk factors of anxious and depression in adolescent children (P<0.05). Conclusion Adolescent girls are the high incidence population of emotional disorder, especially in early adolescence. Lack of parental accompaniment, low parental educational levels, poor parental rela-tionship, bad parenting styles are closely related to anxiety and depression.

Objective To evaluate the clinical value of eversion carotid endarterectomy in patients with carotid atherosclerosis stenosis. Method Summarized the clinical data of 20 patients who accepted eversiou carotid endarterectomy from March 2009 to August 2009, compared the outcomes with preoperative and postoperative image learnt materials and clinical symptoms. Results All cases finished successfully. All clinical symptoms were improved after operation. The stenosis were all improved completely on the image after operation. Conclusions Eversion carotid endarterectomy is safe, effective, and shortening operative time and hospitalization time. It has low restenosis rate, thicken endometrium and plaque can be stripped completely.

Objective To assess the noninvasive index for diagnosing the degree of esophageal varices (EV) in patients with hepatitis B virus (HBV)-related cirrhosis. Methods The clinical data of 112 patients with HBV-related cirrhosis were studied retrospectively. The patients were divided into non-EV (NEV) group (30 cases) and EV group (82 cases) according to the results of gastroscopy. In EV group, there were mild varices in 21 cases (mild EV group), moderate varices in 47 cases (moderate EV group) and severe varices in 14 cases (severe EV group). The age, gender, platelets, glutamyl transpeptidase, prothrombin time, albumin, bilirubin, portal vein diameter, spleen vein diameter and thickness of spleen were compared, and the relationship was analyzed between each index and EV. Results There were no statistical differences in gender, age, albumin, bilirubin, prothrombin time and glutamyl transpeptidase between NEV group and EV group (P>0.05). The portal vein diameter, spleen vein diameter and thickness of spleen in EV group were significantly higher than those in NEV group:(14.1 ± 3.1) mm vs. (10.6 ± 2.3) mm, (8.9 ± 2.1) mm vs. (7.6 ± 1.6) mm and (4.8 ± 0.9) mm vs. (3.8 ± 1.0) mm, the platelets in EV group was significantly lower than that in NEV group:(86.8 ± 20.2) × 109/L vs. (163.5 ± 18.1) × 109/L, and there were statistical differences (P<0.01 or<0.05). The portal vein diameter, spleen vein diameter and thickness of spleen in moderate EV group and severe EV group were significantly higher than those that in NEV group and mild EV group: (13.5 ± 2.1) and (14.8 ± 3.6) mm vs. (10.6 ± 2.3) and (11.2 ± 3.1) mm, (8.3 ± 2.1) and (9.1 ± 1.1) mm vs. (7.6 ± 1.6) and (8.1 ± 1.9) mm, (4.7 ± 1.1) and (4.9 ± 0.9) mm vs. (3.8 ± 1.0) and (4.1 ± 1.2) mm, the platelet levels were significantly lower than those in NEV group and mild EV group: (72.8 ± 11.6) × 109/L and (63.8 ± 15.6) × 109/L vs. (163.5 ± 18.1) × 109/L and (100.2 ± 10.3) × 109/L, and there were statistical differences (P<0.05). The area under curve of response operating characteristic for predicting the presence of moderate and severe EV with portal vein diameter and platelets were 0.719 and 0.735, and the cut off value were 14 mm and 69 × 109/L. Conclusions The portal vein diameter and platelets can predict the presence of moderate and severe EV in patients with HBV-related cirrhosis.

[Objective] To investigate the effect of Xiao Si Wu Granules (XSWG), a preparation composed of Xiao Chaihu Decoction, Siwu Decoction and Witling Powder, on renal renin-angiotensin system (HAS) in diabetic rats. [Methods] Twenty-four Wistar rats were randomly divided into the normal, control and XSWG groups. Except the nonnal group, the rats in other groups were given one-dose intraperitoneal injection of streptozotocin (STZ) 65 mg/kg to induce diabetes mellitus (DM). After the establishment of diabetic models, XSWG group was treated with XSWG 1.8 g?kg-1?d-1 and the other two groups with the same dose of saline for 12 weeks. After treatment, the intrarenal angiotensin Ⅱ (Ang Ⅱ ) concentration was detected with radioimmunoassay method, renocortical antiotensin-converting enzyme (ACE) activity with ultraviolet spectrophotometry and renocortical angiotensin Ⅱ receptor type 1 (AT1) mRNA level with reverse transcriptase polymerase chain reaction (RT-PCR). [Results] AngⅡ concentration and renocortical ACE activity were increased, and renocortical AT1 mRNA level was decreased in the model group, the difference being significant as compared with the normal group ( P

Objective To evaluate the value of acute kidney injury network (AKIN) criteria for predicting hospital mortality in post-cardiosurgery elderly patients. Methods From October 2006 to January 2007, the elderly patients who underwent coronary artery bypass grafting or valve replacement operation were enrolled in this study. The medical data included gender, age, operation type, perioperative hemodynamic parameters, urine output, biochemical parameters and outcome. Renal function was assessed according to the AKIN criteria, and severity of illness was determined after surgery by calculating Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ ) score. Results A total of 225 patients underwent cardiac surgery during this period, 169 patients were male (75. 1%), while 56 were female (24. 9%), mean age was (66. 7±5. 0) years old. The overall hospital mortality rate was 5.8% (13/225). According to AKIN criteria, there were 125 patients with acute kidney injury (55.6%), and the hospital mortality of stage 1, 2 and 3 patients were 2. l%(2/96), 9. 1% (1/11) and 50. 0% (9/18) respectively. A significant increase was observed in mortality based on AKIN criteria (P<0. 01). By applying the area under the receiver operating characteristic curve, the AKIN criteria had a good discriminative power. Conclusions Both the incidence and mortality rate of acute kidney injury in the post-cardiosurgery elderly patients are high, the AKIN criteria is a simple and valuable method with a good prognostic capability for evaluating acute kidney injury.

Objective To explore the therapeutical effects of enteral nutrition (EN) combined with panaxoside Rb1 on mouse modles of postoperative fatigue syndrome. Methods Totally, 72 male Sprague-Dawley mice were randomly divided into control group, model group, EN group, EN associated with high/middle/low dose panaxoside Rb1 groups (EHP group, EMP group, and ELP group, n = 12 in each group). Changes in body weight were measured before and after interventions. Learning and memory playback abilities, physical strength,and vim state were evaluate by Morris Water Maze test and Improved Tail Suspension test. Serum transferrin, prealbumin, fibronectin, and interleukin-2 levels were measured with ELISA. Serum albumin level was assayed with Bromcresol Green colorimetric technique. CD4 + and CD8 + proportions were assayed by flow cytometry. Results The body weight grew alternately in each group without significant differences ( P ＞ 0.05 ) except for model group.The latency period was significantly shorter in EN combined with panaxoside Rbl group than that in model group ( P ＜ 0. 05 ) , and the frequencies of crossing platform in EHP group and EMP group were significantly higher than those in model group ( P ＜ 0. 01 ). The areas of struggling above domain in EHP group and EMP group were significantly larger than those in model group ( P ＜ 0. 05 ), and the accumulated static time of rest in EHP group, EMP group, and ELP group was significantly shorter than that in model group ( P ＜ 0.05 ). Serum transferrin, prealbumin, fibronectin levels in EN combined with panaxoside Rb1 group were significantly higher than those in model group ( all P ＜ 0.05 ). The CD4 + T proportion and interleukin-2 level in EHP group, EMP group, and ELP group were significantly higher than those in model group (both P ＜0.05 ); however, CD8 + T proportion was not significantly different between three panaxoside Rbl groups and model group (P ＞ 0. 05 ). Conclusion EN combined with panaxoside Rb1 can improve postoperative fatigue syndrome in a dose-dependent way, which may be explained by the fact that it can strengthen the postoperative nutrition, restrain hypermetabolism, and increase immunity.

AIM:To explore the effect of HbA1c level in the patients with type 2 diabetes mellitus (T2DM) on the rheological properties of erythrocytes and the structure of hemoglobin (Hb).METHODS:The patients with T2DM were classified into 3 groups:the patients with good glycaemic control (group A, HbA1c<7.0%), the patients with poor glycaemic control (group B, 7.0%≤HbA1c<9.0%) and the patients with persistent hyperglycemia (group C, HbA1c≥9.0%) .The rheological properties of a single living erythrocyte were analyzed by the techniques of static imaging and anal -ysis.Ultraviolet-visible spectroscopy was used to study the structure of Hb .RESULTS: Compared with group H , the roundness effect factor (REF) of erythrocytes, which was positively related with HbA1c level, was significantly increased in groups A, B and C (P<0.05).The contact area of erythrocytes in group B and all the morphological parameters of erythrocytes in group C were significantly higher than those in group H ( P <0.05 ) .There were significant differences among groups A , B and C in deformation capacity and elastic parameters of the cell membrane ( P<0.05 ) , but with no difference in the long axis and short axis between group A and group B .Compared with group H , no obvious change in the spectral pattern and spectrum peak of Hb in groups A , B and C was observed.However, the absorbance of Hb, which showed a trend of gradual decline with the increase in HbA 1c level, in group B and group C was significantly decreased as compared with group H (P<0.01), and the Hb absorbance in group C were also lower than that in group A (P<0.05). CONCLUSION:With the increase in HbA1c level, the morphology along with the deformation function of erythrocytes in T2DM changes and declines gradually , and the structure of Hb may also change .

Objective To investigate the prevention and management of perioperative complications of intertrochanteric fractures in elderly in-hospital patients(aged≥80 years).Methods Clinical data of 103 intertrochanteric fracture patients(31 male and 72 female)undergoing surgical treatment at our hospital from May 2010 to Nov.2015 were retrospectively analyzed.Their ages ranged from 80 to 99 years,with an average of 86.2 years.There were 3 Evan type Ⅰ cases,25 type Ⅱ cases,36 type Ⅲ cases,37 type Ⅳ cases and 2 type V cases.Of these,82 received epidural anesthesia and 21 had general anesthesia.Intertrochanteric fractures were treated with proximal femoral nail(PFN) internal fixation in 101 patients and dynamic hip screw(DHS)internal fixation in 2 patients.Results The average operation duration and blood loss were 30 min and 60 ml in the PFN internal fixation group and 60 min and 150 ml in the DHS internal fixation group,respectively.The average hospitalization time was 16.7 days.One patient (0.9％) died after operation,10 (9.7％) had preoperative complications of bed rest with 3 cases involving the central nervous system and 4 cases involving the respiratory system,and 38 cases (36.9％)had postoperative complications with 13 involving the central nervous system.The average time from admission to operation was 6 days,with 65 cases above the average and 38 cases below the average,and there was a statistically significant difference in the incidence of postoperative complications between the two subgroups(30/65 or 46.2 ％for the former and 8/38 or 21.1％ for the latter,x2＝6.49,P＜0.05).Conclusions Elderly patients with intertrochanteric fractures should undergo surgery as soon as possible,preferably with epidural anesthesia.Proficiency in surgical kills,short operation time,close monitoring of preoperative and postoperative conditions,and proper and timely treatment are the key to ensuring surgical success.