Guillain-Barré syndrome(GBS) has clinical characteristics:flaccid,symmetrical,ascending paralysis.Cranial nerves and respiratory muscle related,albuminocytologic dissociation in cerebrospinal fluid,and electrophysiological changes.GBS was believed to be an autoimmune perineuropathy.Recently,there were more and more reports about GBS spectrum disorders or GBS variant correlated with anti-GQ1b antibody or anti-GM1 IgG antibody et al.The GBS Classification Group presented the new clinical criteria in 2014,to enable neurologists and non-neurologists to diagnose GBS and all its variants using a simple yet all-inclusive classification system.

Objective To investigate how internet using (both time and activities)and effortful control would contribute to the sex difference of problematic internet use (PIU).Methods A total of 844 adolescents aged 9-20 years old were selected from Chinese Academy of Sciences twin-sample by simple random sampling,with boys accounting for 45.6％ and girls accounting for 54.4％.The internet using and effortful control were measured using self-report questionnaires in the first time(T1),the problematic internet use were measured after one and half years (T2).The difference and relation of Internet using,effortful control and problematic internet use between boys and girls were measured with Chi-square test,t test and correlation analysis.The moderating effect of sex between internet using and PIU were explored by utilizing regression analysis.The mediation effect of effortful control between sex and PIU were explored with Sobel test.Results The anverage internet time of working day and weekend in boys were 1.52 h and 2.12 h respectively.The average internet time of working day and weekend in girls were 1.49 b and 2.05 h respectively.Significant difference between boys and girls is not existed in the internet time (t=0.541,0.907,P＞0.05).And the boy was inclined to game(x2 =47.669,P＜0.01).The effortful control of boys and girls were 54.09 and 55.76 respectively.The score of boys' and girls' PIU were 22.48 and 20.72 respectively.Boys' effortful control was significantly lower than that of girls (t=-2.879,P＜0.01).The score of boys' PIU was significantly higher than that of girls' (t=3.612,P＜0.01).Adolescents' PIU were significantly correlated with the time,entertainment and social activities (r=0.249,0.175,0.140,P＜0.01).The moderating effect of sex was significant in the relation between internet time and PIU.Significant mediation effect of effortful control existed in the PIU difference between boys and girls(Z=-2.54,P＜0.05).Conclusion Significant mediation effect of effortful control exists in gender and PIU.

Objective To analyze the correlation between the resistance of Acinetobacter baumannii and the utilization of antimicrobial agents in the hospitalized patients of Beijng Chuiyangliu Hospital,and provide the basis for clinical rational use antimicrobial agents.Methods A retrospective analysis was conducted for the drug resistance rate and specimen source of the 2 194 strains of Acinetobacter baumannii from 2010 to 2014 in the hospital and DDDs/DUI of antimicrobial agents was analyzed by Pearson correlation.Results The resistance rate of Acinetobacter baumannii was positively correlated with the DDDs and DUI of imipenem/cilastatin(r=0.991,0.994,all P<0.01), and was positively correlated with the DDDs of cefepime(r=0.934,P=0.020).The resistance rate of Acinetobacter baumannii to amikacin was positively correlated with the DDDs of etimicin(r=0.931,P=0.022).The resistance rate of Acinetobacter baumannii was negatively correlated with the DUI of levofloxacin(r =-0.986,P =0.002). Conclusion The resistance rate of Acinetobacter baumannii was high and there was correlation between the drug resistance and the utilization of some antimicrobial agents.

Objective To explore the correlations of lung resistance protein (LRP) and glutathione S transferase π (GST-π) to chemotherapy resistance and prognosis of epithelial ovarian cancer.Methods The expressions of LRP and GST-π in epithelial ovarian cancer were examined with immunohistochemistry.Correlations of LRP and GST-π to chemotherapy efficacy and survival time after operation were analyzed.Results The short-term efficacy rates of ovarian cancer were lower in patients with positive expressions of LRP and GST-π than those with negative expressions [61.2％,61.7％ vs 94.1％,89.5％,x2 =6.47,4.94,P =0.011,P =0.026].The positive rates of LRP and GST-π were significant higher in patients with chemotherapy resistance than in those sensitive to chemotherapy [91.3％,87.0％ vs 65.1％,62.8％,P ＜ 0.05].Log-rank test showed that patients with positive LRP and GST-π had shorter survival time than those negative,and patients with both positive LRP and GST-π had shorter survival time than those both negative (P ＜ 0.05).Conclusions The expressions of LRP and GST-π in epithelial ovarian cancer could be used to predict chemotherapy resistance and prognosis of patients.

OBJECTIVE:To establish the pharmacokinetic-pharmacodynamic(PK-PD) model of Nisoldipine controlled-release patches(NCRP)in spontaneously hypertensive rats(SHR). METHODS:SHR were randomized into a patch(NCRP)group and a tablet(Nisoldipine tablets)group,with 6 rats in each group. The microdialysis probes were implanted in SHR. Each rat was given 5 mg nisoldipine. Plasma microdialysate was collected within 36 h after administration. HPLC was adopted to determine the plasma concentration of nisoldipine,and WinNonlin 5.3 was employed to calculate Pharmacokinetic parameters. With heart rate and blood pressure as pharmacodynamic indexes,PK-PD model study was conducted. RESULTS:Vs. nisoldipine tablets,NCRP has con-trolled release effect. The relationship between NCRP drug effect and effect-site concentration met the Sigmoid-Emax model. The main parameters of the PK-PD model for heart rate and systolic blood pressure were as follows as Emax of (2.65 ± 0.06) and (10.71 ± 0.87),EC50 of (83.65 ± 35.25) and (1.29 ± 0.26) ng/ml,γ of (0.83 ± 0.91) and (1.2 ± 0.35),Keo of (0.37 ± 0.53) and (0.91±0.24)h-1. CONCLUSIONS:PK-PD model of NCRP in SHR has been established successfully.

Objective To establish an animal model of high-iodine and low-protein in Wistar rats,and to observe the effect of combined excess-iodine and low-protein diet on growth,metabolism and morphological changes in thyroid.Methods According to body weight[(110 ± 10)g] and sex(half male and half female),one hundred and ninety-two Wistar rats,1 month after weaning,were randomly divided into ① normal iodine control group (NI),② 10-fold excess-iodine group (10HI),③ 50-fold excess-iodine group (50HI),④ 100-fold excess-iodine group (100HI),⑤ low-protein control group (LC),⑥ low-protein and l 0-fold excess-iodine group (L10HI),⑦low-protein and 50-fold excess-iodine group (L50HI),⑧ low-protein and 100-fold excess-iodine group(L100HI).Twenty-four rats were in each group,with the experimental period of 6 months.The iodine content of NI and LC groups was 4.65 μg/d; 10HI,50HI and 100HI groups were 46.50,232.50 and 465.00 μg/d,respectively.The animal's body weight,water and feed consumption were recorded weekly.At the end of 60,120,180 days,urine and blood samples were collected from eight rats in each group.Urinary iodine was tested by arseni cerium catalytic spectrophotometry; serum iodine was tested by the method of chloric acid.Histological change of the thyroid gland was observed by transmission electron microscopy and hematoxylin-eosin (HE) staining at the end of 6 months; apoptosis of thyroid was tested by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) method.Results At the end of 4,8,16,18,22 and 24 weeks,the differences of body mass of rats among groups were statistically significant(F =4.26,3.75,4.98,4.09,3.28,3.95,all P ＜ 0.05).At the end of 60,120,180 days,the differences of iodine concentration in urine and blood among groups were statistically significantly (H =5.37,6.03,all P ＜ 0.05).Light microscopy showed that thyroid follicular epithelial cells became flattened,and follicles became distended with colloid following increasing of iodine concentration.Electron microscopy showed increased glial vesicles,condensation of nuclear chromatin,karyopyknosis,and karyolysis with increasing of iodine concentration.The differences of apoptotic indexes among groups were statistically significant (F =4.59,P ＜ 0.01).The apoptotic indexes of L50HI and L100HI groups [(21.50 ± 5.20)‰,(26.70 ± 6.40)‰] were higher than those of 50HI and 100HI groups [(11.20 ± 4.30)‰,(19.40 ± 4.80)‰,P ＜ 0.01 or ＜ 0.05].Conclusion Excessiodine and low-protein can cause growth retardation,abnormal iodine metabolism,and thyroid follicular epithelium damage in Wistar rats.

Objective To explore the effects ofBuzhong Yiqi Pills on HBV-related decompensated liver cirrhosis patients.Methods A total of 176 patients of HBV-related decompensated liver cirrhosis were enrolled in the study from January 2007 to January 2010 and were divided into treatment group (82 cases) and control group (94 cases) according to patient's wishes. Patients in both groups were given antiviral therapy. According to the liver function and complications, patients were given glycyrrhizin to protect liver, Kuhuang Injection to treat jaundice, and spironolactone and furosemide for diuretic treatment. Patients in the treatment group receivedBuzhong Yiqi Pills, one bag for each time, twice a day, four weeks as a treatment session, three sessions each year, with five-year follow-up. Effects ofBuzhong Yiqi Pills on the hepatorenal function, blood coagulation, blood routine, complications and survival rate in patients with decompensated liver cirrhosis were observed.ResultsBuzhong Yiqi Pills could effectively improve the hepatorenal function, blood routine and coagulation disorders of HBV-related decompensated liver cirrhosis patients (P<0.05,P<0.01). The rate of complications with hydrothorax and ascites (46.34% vs. 88.30%), upper gastrointestinal hemorrhage (39.02% vs. 69.15%), infection (31.71% vs. 57.45%), hepatic encephalopathy (23.17% vs. 54.26%), hepatorenal syndrome (6.10% vs. 18.09%) and chronic hepatic failure (9.76% vs. 25.53%) in the treatment group and the control group were with statistical significance (P<0.05,P<0.01). The five-year survival rates were significantly higher in the treatment group (79.27%) compared with the control group (64.89%), with statistical significance (χ2=5.353,P=0.021).ConclusionLong term use ofBuzhong Yiqi Pills can significantly decrease the complications of HBV-related decompensated cirrhosis and improve survival rate of patients.

The establishment of medical morality and behavior appraisal system and research on its application developed in comprehensive hospitals were clarified.Several aspects related to the medical morality and behavior appraisal,such as index,standard,approach,method,record and the result,were investigated and practiced,and the establishment of a scientific and reasonable medical morality and behavior appraisal system was investigated in the aspects of consummating the organization management of medical morality appraisal,subdividing the medical morality appraisal system,quantifying the medical morality appraisal standard,operating and performing the medical morality appraisal and establishing the electronic archives of medical morality appraisal to construct an efficient incentive and restraint mechanism,and moreover,to promote the establishment of hospital convention and the enhancement of the overall management level.

Objective To evaluate the relationship between endoscopic rectal aberrant crypt foci (ACF) and colon neoplasm, including lesions with high risk of aggressive progression (adenoma with diameter ≥ 1cm, villus adenoma, tubular-villus adenoma, adenoma of high grade dysplasia, or cancer). Methods The rectum of 212 patients who underwent colonoscopy was stained by 0. 4% indigo armine, and the patient was classified into different grade according to the number of rectal ACF, namely Grade 0 as no ACF, Grade Ⅰ as 1-4, Grade Ⅱ as 5-9 and Grade Ⅲ as more than 10. The correlation between rectal ACF grade and colon lesions was analyzed. Results Of 212 patients, 72 were classified as Grade 0, 48 as Grade Ⅰ , 41 as Grade Ⅱ, and 51 as Grade Ⅲ. The detection rate of colon neoplasm and lesions with high risk of aggressive progression in patients with rectal ACF were significantly higher than that in patients without rectal ACF (OR at 95% CI was 22. 352 (6. 716 -74. 395) and 7. 982 ( 1. 838-34. 672), respcetively). Conclusion Rectal ACF may predict the detection of colon lesions, including those with high risk of aggressive progression.

Objective To investigate the correlation between the drug resistance of Helicobacter pylori (H .pylori )and clinical eradication efficacy of bismuth-based quadruple therapies,and to guide clinical rational drug use in the region.Methods A total of 260 patients with H .pylori infections were collected.H .pylori from biopsied gastric mucosa tissues were isolated and cultured.Drug resistant rates of isolated H .pylori to metronidazole,clarithromycin,amoxicillin,levofloxacin and furanzolidone were tested.Patients were randomly divided into clarithromycin,levofloxacin,furanzolidone and metronidazole groups by completely randomized design.All patients received bismuth potassium 220 mg,esomeprazole 20 mg and amoxicillin 1 000 mg twice daily,and according to group received clarithromycin 500 mg, levofloxacin 200 mg,furanzolidone 100 mg and metronidazole 400 mg,twice daily,espectively.The treatment course was 10 days.At least four weeks after treatment,13 Curea breath test or 14 Curea breath test was taken.According to the intention to treat (ITT)and per-protocal (PP),the eradication rate of each group was caculated.Chi square test was performed to compare the differences between groups. Results The drug resistant rate of H .pylori to metronidazole,clarithromycin,amoxicillin,levofloxacin and furanzolidone was 94.2% (146/155 ), 21 .3% (33/155 ), 2.6% (4/155 ), 5 .8% (9/155 ) and 1 .9%(3/155),respectively.According to ITT analysis,the eradication rate of clarithromycin group, levofloxacin group,furanzolidone group and metronidazole group was 81 .5 %(53/65 ),90.8%(59/65 ), 93.8% (61/65 )and 75 .4%(49/65),respectively.And according to PP analysis which was 84.1 %(53/63),92.2%(59/64),95 .3%(61/64)and 79.0%(49/62 ),respectively.The differences between furanzolidone group and metronidazole group,clarithromycin group were staistcally significant (χ2ITT =8.509 and 4.561 ;χ2PP = 7.592 and 4.323,all P < 0.05 ).There was no statistical significance in the H .pylori eradication rate between resistant strains and sensitive strains of each group.Conclusion Bismuth-based quadruple therapy can overcome antibiotic resistance,the eradication rate of protocal with furanzolidone is higher and with good safety,which can be the first-line treatment for H .pylori eradication.