Objective To investigate the value of brainstem auditory evoked potential (BAEP) in early diagnosis of severe hand,foot and mouth disease (HFMD) with the nervous system damage.Methods BAEP was performed in 297 cases with HFMD.The patients were divided into 4 groups by the HFMD clinical classification and their ages.Group A included the general cases who were younger than three years (n =80).Group B included the severe cases who were younger than three years(n =94).Group C included the general cases who were three years or older(n =38).Group D included the severe cases who were three years or older(n =85).The electroencephalogram (EEG) and MRI results of patients in the groups were retrospectively studied and the results were compared with that of BAEP.Results (1) The BAEP abnormal rate of group B (18/94,19.15％)was higher than that of group A (3/80,3.75％),and the BAEP abnormal rate of group D (13/85,15.29％) was higher than that of group C (1/38,2.63％) (P ＜ 0.05).(2) The EEG abnormal rate in group B was low(2/94,2.13％) and there was no case with abnormal EEG in group A.(3) The EEG abnormal rate of group D (49/85,57.65％) was higher than that of group C (6/38,15.79％) (P ＜0.05),and higher than the BAEP abnormal rate of group D.(4) The MRI abnormal rate of group B (9/94,9.57％) was higher than that of group A (1/80,1.25％) (P ＜ 0.05),and the MRI abnormal rate of group D (9/85,10.59％)was higher than that of group C (0).(5) The BAEP abnormal rate of the children with severe HFMD (31/179,17.32％) was higher than the MRI abnormal rate (18/179,10.06％) (P ＜0.05).Conclusion BAEP has clinical significance for early diagnosis of severe HFMD with nervous system damage,and can provide objective basis for the diagnosis.

Objective Discuss how to develop nurse arrange in groups mode in basic level hospital, resolve more effectively the problem of nurse delayed on duty to ensure nursing care quality and patients' safety.Methods Divide nurses of different level, different working ability and work experience into several groups to carry on arranges in groups.According to the quantity of patient in ward, the nursing work load, nurse establishment and so on, arrange groups with different number of nurse to attend duty.Results Realized nurse level management, the senior nurse's sense of responsibility strengthened, the work value feeling promoted, nurse delayed on duty rate reduced 89.5%;has realized three satisfactions, namely doctor, nurse, the patient were satisfied.Conclusion Basic level hospital, according with practical work characteristics, develop arranges in groups pattern continuously, and thus has safeguarded the noon and at night patient's safety well, has manifested truly take the patient as the center service idea;reduced times of handover, effectively save time of work, raises the working efficiency, reduces the safe hidden danger;realized nurse level management, enhanced nurse the value feeling.

The development of the minimally invasive targeted ablation tendency creates a new therapy for lung cancer. This treatment is featured with considerably extensive indication ,excellent local control and survival time, low incidence and controllable complications. There are many strong proofs of clinical efficacy and safety in this field presently.

OBJECTIVE To discuss the management experience of protective measures for emergently admitted influenza H1N1 patients in our hospital who were converted from general ward into isolated ward in no more than three hours.METHODS Laying out the guideline of the work,personal training and personal protective measures were taken to manage the staff who working in the isolated ward.RESULTS There was statistically significant difference in hand washing,wearing mask and head wear,taken off gloves,mask and clothes among medical staff who worked in the isolated ward,in comparison with staff from other ward and non-medical staff From 14 points of suruey.there were 8 points were over 80% pass rate.The use of protective equipment was correct.without any cross infection.CONCLUSIONS Management of protective measures plays an important role in control of cross infection in treatment of H1N1 patients.

Objective To investigate the changes of liver function and white blood cell of patients with liver cirrhosis,portal hypertension and secondary hypersplenism underwent laparoscopic splenectomy(LS) and open splenectomy(OS).Methods We analyzed 76 clinical data of patients with liver cirrhosis,portal hypertension and secondary hypersplenism,among those 27 underwent LS,49 OS from Mar 2003 to Mar 2006 retrospectively.Blood samples were obtained and analyzed preoperatively and postoperatively on days 1,3, and 7,including alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBil),directed bilirubin(DBil) and white blood cell(WBC).Results Between LS and OS,the serum levels of Tbil and Dbil had significant difference on the 1st postoperative day(P

Objective To analyze the influences of lacrimal secretion and tear film after interferon-alpha therapy in patients with chronic viral hepatitis.Methods Sixty patients with chronic viral hepatitis who would accept the interferon-alpha therapy,including 30 cases of hepatitis B and 30 chronic viral hepatitis C,visited our department of ophthalmology and were enrolled in this study.All cases received eye examination,including medical history,slit lamp examination,corneal fluorescein staining ( FL) ,tear film break-up time ( BUT) and schirmer test before inter-feron-alpha therapy and two months after the therapy.Results In the 60 cases of chronic viral hepatitis,there were 19 dry eye cases (31.67%) and 41 non-dry eye cases (68.33%).In dry eyes group,9 of them (47.37%) were hepatitis B patients and 10 of them were hepatitis C patients (52.63%) .There was significant difference in FL grade (t=-5.288,P<0.05),BUT (t=5.799,P<0.05),Schirmer Ⅰ(t=5.319,P<0.05) test in hepatitis B before and two months after interferon-alpha therapy.Statistical significance had been found before and two months after therapy in FL grade (t=-9.103,P<0.05),BUT (t=5.682,P<0.05),SchirmerⅠtest (t=4.592,P<0.05). The incidence of dry eye syndrome in hepatitis B patients increased from 26.70%to 53.30%two months after treated with interferon-alpha,while the incidence of dry eye syndrome in hepatitis C patients increased from 33.30% to 60.00% two months after treated with interferon-alpha.Conclusion Dry eye syndrome is one of common complica-tions in patients with chronic viral hepatitis.Interferon-alpha therapy would influence the lacrimal secretion and dam-age tear film,which increased the dry symptoms in patients.We should pay attention to the side effects of interferon-alpha therapy.

Objective To study the efficiency of the first time platelet transfusion in patients with blood diseases.Methods Investigate the effect of platelet transfusion in 87 patients with blood diseases.All the patients were transfused 10U platelet (platelet≥2.5×1011 ).Observe CCI after platelet transfusion and analyse the influence factors to the efficiency of the first time platelet transfusion such as the kind of diseases,splenomegaly,fever,age and sex.Results After platelet transfusion,66 patients (75.9 ％) were effective.The efficancy rates were 80.0 ％,78.1％,65.2 ％,82.3 ％ in AA,ITP,AL,MDS (x2=2.88,P＞0.05).In 31 patients with a fever and infaction the efficancy rate was 58.1％,but it was 85.7％ in 56 patients without a fever and infaction (x2=8.3308,P＜0.01).The efficancy rate in 59 patients with non-splenomegaly was 86.4 ％.It was higher than that in 28 patients with splenomegaly which was 53.6％(x2=11.2033,P＜0.01).The efficancy rate was 76.0％ in male patients and it was 75.7 ％ in female patients (x2=- 0.0012,P＞0.05).The efficancy rate was 74.5 ％ in young group (＜60 years old)and 77.8 ％ in old group (≥60 years old)(x2=0.1231,P＞0.05).Conclusion Fever and splenomegaly are the influence factors to the efficiency of the first time platelet transfusion.

Objective Recently, the role of TREK-1 in anti-depression and neuroprotection was demonstrated definitely.In this paper,a systematic review about the functional structure of TREK-1 as well as the underlying mechanisms which involved in depression resistance and nerve protection was made for purpose of providing new ideas for the treatment of clinical diseases.Methods The electronic search of Medline/PubMed,CNKI,CBM and Wanfang Data were performed to collect the introduction of TREK-1 and the studies of depression and nerve protection in which TREK-1 participated from inception of each database to October 2015 ,besides the relevant references of the included studies were also retrieved.Results 30 studies were included in this paper.14 studies were about the interpretation of TREK-1's structure, distribution and the regulatory factors, and the number of researches regarding the involvement of TREK-1 in anti-depression and neuroprotection was 13 and 7 respectively.Based on these studies,it was easily to conclude that inhibition or blocking of TREK-1 channels can produce obvious antidepressant effect, however, activation of TREK-1 channels will induce the dilation of local cerebral vascular and silence hyperactive neurons.Conclusion Some achievements about the antidepressant and neuroprotective effect of TREK-1 channels in vivo have been made gratifyingly,thus future research should focus on exploring the best TREK-lactivation ratio in different brain regions to gain the best balance between anti-depression and neuroprotection.

The concentrations of berberine (BBR) and 8-cetylberberine (8-BBR-C16) in rat plasma and tissue were determined by RP-HPLC. Both the plasma pharmacokinetics characteristic and tissue distribution differences of BBR and 8-BBR-C16 were compared to provide experimental data for the mechanism research and further drug development. After the oral administrations of BBR and 8-BBR-C16 at the dose of 80 mg x kg(-1) for rats, the pharmacokinetics result showed that compared with BBR, the C(max) and AUC(0-t), of 8-BBR-C16 increased by 2.8 times and 12.9 times respectively, t1/2 extended from 3.61 h to 11.90 h. The tissue distribution result showed that compared with BBR, the concentration of 8-BBR-C16 in various organizations increased and the retention time extended remarkably. The maximum concentration was achieved in lung and the highest concentration in it was 3 731.82 ng x g(-1). After being derived, the C(max) in plasma and bioavailability of 8-BBR-C16 increased remarkably and the circulation time in vivo extended. The drug concentration in tissue increased remarkably, and the distribution ratio changed too, with strong targeting selection in lung.

Objective To evaluate the value of serum procalcitonin(PCT ) and C-reactive protein(CRP) analysis in the differenti-ation of the cause of fever in cancer patients .Methods 218 cases with fever enrolled were divided into three groups ,including bacte-rial infection group ,viral infection group and tumor related fever group .The positive rates of white blood cell(WBC) count ,percent-age of neutrophil ,PCT and CRP were determined and there correlations were analyzed .Results The positive rates of WBC count , percentage of neutrophil ,PCT and CRP in bacterial infection group were significantly increased compared to viral infection group and tumor related fever group(P<0 .05) .The positive rate of PCT in tumor related fever group was also statistically significant difference compared to viral and bacterial infection group(P<0 .05) .The sensitivity of PCT was 97 .83% and the specificity of PCT was 83 .33% .Conclusion PCT and CRP can help identify causes of fever in cancer patients .PCT has better sensitivity and specific-ity ,it can help anti-infective and provide experimental evidence for tumor treatment ,and also help determine the disease outcome and clinical deterioration .