Objective:To summarize the clinical features,diagnosis and treatment on patients with severe craniocerebral traffic accident trauma combined with chest injuries.Methods:The data of 53 patients with severe craniocerebral traffic accident trauma combined with chest injuries in the department where the authers worked were studied retrospectively.Results:27 patients were cured,16 patients survived with disabilities.1 patient survived in vegetative state,9 patients died.Conclusion:The traumatic condition of the patients with severe craniocerebral traffic accident trauma with chest injuries is always complicated and serious,and the mortality rate of these patients is high.Early diagnosis and prompt treatment,avoiding missed diagnosis and misdiagnosis were crucial for these patients.Keeping respiratory tract unobstructed,treating shock,cooperation among relevant departments are important to rescue the patients.

Objective To explore the value of ultrasound in assessment of treatment effect of diffuse toxic goiter.Methods 80 diffuse toxic goiter patients with 131I therapy were selected as research subjects.Before and after treatment,the serum thyroid hormone levels were detected and thyroids were checked by ultrasound.Results Before and after treatment,the FT3 levels were positively correlated with blood flow area ratio and flow grade (r =0.472,0.593,all P ＜ 0.05).After treatment,the thyroid weight,peak systolic velocity(PSV) and end diastolic velocity (EDV) [(12.89 ± 7.86) g,(32.24 ± 21.85) cm/s,(12.36 ± 19.22) cm/s] were significantly lower than those of before treatment [(30.12 ± 17.24) g,(68.58 ± 34.25) cm/s,(28.03 ± 21.24) cm/s] (t =11.265,4.762,3.672,all P ＜ 0.05).Before and after treatment,the RI and PI showed no significant difference(all P ＞ 0.05).The difference of thyroid blood flow grade before and after treatment was statistically significant (x2 =98.959,P =0.000),the proportion of flow grade class Ⅲ before treatment was higher(80.0％),while the proportion of flow grade class Ⅰ after treatment was higher(60.0％).After treatment,the FT3 and FT4 levels [(6.88 ± 4.14)pmol/L,(17.23 ± 7.35)pmol/L]were significantly lower than those of before treatment [(18.79 ± 6.45) pmol/L,(56.47 ± 22.97) pmol/L] (t =17.243,13.254,all P ＜ 0.05).The TSH level [(11.52 ± 8.27) mU/L] was significantly higher than that of before treatment[(0.01 ± 0.00)] mU/L (t =3.365,P ＜ 0.05).After treatment,the thyroid weight,PSV and EDV of cure group[(9.34 ±2.36) g,(20.13 ± 8.59) cm/s,(9.13 ± 5.34cmn/s)] were lower than those of non-cure group [(18.78 ± 8.76) g,(52.32 ± 13.24) cm/s,(17.24 ± 8.34crn/s)] (t =9.143,8.793,5.232,all P ＜ 0.05).The differences of RI and PI in the cure group and non-cure group were not statistically significant (all P ＞ 0.05).Conclusion Ultrasound has a better role in the evaluation effect of 131I therapy for diffuse toxic goiter.

Objective To investigate curative efficacy of interferon in combination with ganciclovir in treatment of herpes zoster and its effects on post herpetic neuralgia and IL-6, IL-10.Methods 106 patients of herpes zoster who received therapy in Heilongjiang electric power hospital from January 2014 to February 2015 were selected as research objects.Those patients were divided into control group(n=52) and observation group(n=54) by random number table.All patients were given symptomatic treatments, such as analgesia.Besides that, control group was treated with ganciclovir, while observation group was treated with interferon in combination with ganciclovir.Then, the curative efficacy of herpes zoster, incidence of post herpetic neuralgia, pain score of patients with post herpetic neuralgia and levels of inflammatory factors were compared.And during the treatment, adverse reactions were observed.Results After treatment, the total therapeutic efficacy ratio of herpes zoster in observation group and control group was 92.6% and 78.8% respectively with statistical difference(P<0.05).And incidence of post herpetic neuralgia in observation group and control group was 44.4% and 50.0% respectively with no statistical difference.Score of VAS which reflects pain in observation group after the treatment was statistically lower than that in control group in patients with post herpetic neuralgia(P<0.05).As to inflammatory factors, in comparison with control group, level of IL-6 in observation group was statistically lower [(137.6 ±32.4) pg/mL vs(340.5 ±30.6) pg/mL, P<0.05] and level of IL-10 was statistically higher [(179.3 ±22.5)μg/mL vs(150.6 ±24.1)μg/mL, P<0.05].During the treatment, there was no case of severe adverse reaction. Conclusion Interferon in combination with ganciclovir is effective for herpes zoster, which can significantly increase curative efficacy, alleviate pain degree of post herpetic neuralgia with minor adverse reactions .

Professor JIANG Yu-ren,a famous pediatrist of TCM in present age,has been engaged in clinic,teaching and scientifi c research of TCM pediatrics for 60 years.His achievement is remarkable.Especially,he has rich clinical experience in acute febricity of paediatrics,such as critical encephalitis B and serious measles complicated by pneumonia.He puts forward the rule of treating measles with favourable prognosis by method of dispersing-promoting,cooling-relieving and nourishing ying,treating measles with reverse prognosis by method of clearing heat,cooling blood and reviving yang and treating measles complicated by pneumonia should use the method of promoting pathogenic factors,removing toxic substance and relieving exhaustion.

s Objective To select the appropriate upgrading solutions for hospital department-level Mini-PCAS system. Methods Based on the analysis of the inadequacies of the GE-PACS/RIS system in hospital,it was proposed that hospital should upgrade the existing system from both hardware and software. Results The system not only enhanced the working efficiency but also enhanced and expanded the functions in management in some image department. Conclusion With the advantages of foreign PACS and domestic RIS system,the system is an appropriate solution.

?7nAChR, an important neurotransmitter recptor,is w il dly expressed in the central and peripheral neuronal system, which is involved i n neuronal signal transduction and the regulation of physiological functions in the central neuronal system. Several studies have demonstrated that ?7nAChR is identified in non-neuronal cells such as endothelial cells, vascular smooth mus cle cells, bronchial epithelial cells, skin keralinocytes and is involved in the regulation of mitosis,differentiation, organization of the cytoskeleton, cell -cell contact, locomotion and migration. These (in vitro and in vivo) s tudies indicated that ?7nAChR participated in the secretion and release of seve ral bioactivity molecules in endothelial cells, mediated intercellular signal tr ansduction, and regulated angiogenesis. These studies suggested an endogenous ch olinergic target for angiogenesis mediated by endothelial ?7nAChR.

Objective To explore the significance of detection serum Retinol-Binding Protein and AnnexinA2 in diabetic ne-phropathy.Methods According to 24-UAER level,80 diabetic patients with suspected DN were devided into three groups, that was A (25 cases),B (26 cases)and C (29 cases)group,and control group (NC)was 25 cases.HbA1c,BUN,Scr,UA and RBP leves were detected by the standard method.The expression level of Annexin A2 were detected by real-time PCR. Results There were obvious differences of HbA1c,BUN,Scr,UA and RBP levels among three groups and NC group (t=4.64~13.65,P<0.05),To HbA1c,BUN,Scr and UA,no differences between A group and B groups (t=0.31~1.25,P>0.05),there were differences of RBP (t=15.26,P<0.05).To HbA1c,BUN,Scr UA and RBP,there were differences be-tween A groups and C groups (t=5.26~25.33,P<0.05),there were the same results between B groups and C groups (t=4.02~18.33,P<0.05).To expression level of AnnexinA2 there were differences among three group and NC group ((t=13.45~24.25,P<0.05)).There exist positive correlation between the expression of AnnexinA2 and RBP level (r=0.95, P<0.01).Conclusion Combined detection of serum RBP and expression level of AnnexinA2 may be a sensitive and early phase indicator for impairment of renal function for diagnosis of diabetic nephropathy.

Objective To explore the influence of gestational diabetes mellitus(GDM)on pregnancy and delivery outcomes.Methods 278 pregnant women with GDM were chosen as experimental group who underwent their antenatal care and delivery in Liuhe People's Hospital in Nanjing,according to the 75g oral glucose tolerance test(OGTT)performed in pregnant women at 24-28 pregnancy weeks from January 2014 to October 2015.Meanwhile,the other 278 healthy women were chosen as control group.The pregnancy and delivery outcomes of the two groups were compared.Results The 24-28 weeks' 3 time-point OGTT blood glucose (FPG,1 h PG and 2 h PG) (mmol/L) values of experimental group were 5.08±0.56,9.22±1.71 and 7.62±1.48 respectively,which were significant higher than that of control group:4.45 ± 0.43,7.76 ± 1.35,6.34±4 0.96 (P＜0.05).The incidences of pregnancy-induced hypertension syndrome,premature rupture of membranes,premature birth,fetal distress,postpartum hemorrhage,macrosomia and cesarean delivery of experimental group were significantly higher than that in control group (P ＜ 0.05).Conclusion GDM has a relatively large effect on pregnancy outcomes,causing serious complications of maternal and infant.Therefore,glucose metabolism during pregnancy should be surprised closely and education should be conducted to improve maternal and neonatal outcomes.

Objective: To predict the risk of cognitive decline among elderly patients with type 2 diabetes mellitus (T2DM), so as to provide insights into the early identification of cognitive decline in elderly patients with T2DM. Methods: The elderly patients with T2DM hospitalized in the Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University were selected as subjects. General information was collected by a questionnaire survey, including demographics and nutritional status, and cognitive decline was assessed using the frailty Phenotype Scale, the Montreal Cognitive Assessment and the Clinical Dementia Rating. Multivariable logistic regression model was used to analyze the influencing factors of cognitive decline among elderly patients with T2DM. A nomogram was established, and was verified with Bootstrap resampling method and receiver operation characteristic curve. Results: A total of 270 questionnaires were sent out and 262 valid questionnaires were collected, with an effective rate of 97.04%. There were 137 males (52.29%), 146 patients at ages of 60 to 69 years (55.73%), 179 married patients (68.32%), and 85 patients with cognitive decline (32.44%). Multivariable logistic regression analysis identified gender (female, OR=3.118), age (70 to 79 years, OR=3.218; 80 years and older, OR=3.058), educational level (high school or technical secondary school, OR=0.335; junior college, OR=0.130; college and above, OR=0.300), regular exercise (OR=0.083), memory (decreased, OR=29.723), nutritional status (risk of malnutrition, OR=16.307; malnutrition, OR=39.469), activity of daily living (decreased, OR=6.804) and depressive symptoms (OR=8.609) as factors affecting cognitive decline among elderly patients with T2DM (all P<0.05). The nomogram based on the above factors fit well and indicated strong predictive ability. Conclusion Gender, age, educational level, regular exercise, memory, nutritional status, activity of daily living and depressive symptoms can effectively predict the risk of cognitive decline among elderly patients with T2DM.

Objective To evaluate the applicability and effectiveness of the model for managing patients with convulsive epilepsy in rural China.Methods The model is under leadership of the government departments and medical institutions at all levels organized primary physicians for treatment and management.People with convulsive epilepsy in 24 rural areas were screened by local physicians and confirmed by neurologists.Patients diagnosed with convulsive epilepsy and agreed with managing were recruited into study.They were managed at primary care level and provided with phenobarbital monotherapy.Efficacy was assessed from the changes in seizure frequencies from baseline.Results There were 408 town hospitals and 979 trained primary care physicians participating in our study.Five thousand and thirty-eight patients were enrolled in 2 years,and 90％ patients with good compliance.Among the people who were treated with phenobarbital monotherapy,3 170 were managed for 12 months,and 2 005 (63.3％) of whom had a 50％ or greater reduction in seizure frequency and 1 246 (39.3％)patients remained seizure free;651 patients were managed for 24 months,and 491 (75.4％) of whom had a 50％ or greater reduction in seizure frequency and 202(31.0％)patients remained seizure free.Three hundred and forty-three (6.8％) patients withdrew from the study,and only 35 (0.7％) patients discontinued treatment because of side effects.Sixty-nine (1.4％) patients were dead and 8 (11.6％) of them were caused by status epilepticus.Conclusion This study confirms that this model is beneficial to patients with epilepsy and is suitable to the rural areas of China.