Humans ; Lead ; urine ; Lead Poisoning ; diagnosis ; urine ; Spectrometry, Fluorescence ; methods ; Spectrophotometry, Atomic ; methods

With the appearance of new biological agents represented by infliximab,the medical therapy of crohns' disease has made breakthrough of progress.However,the controversial still remains about the use of infliximab during perioperative period in Crohn's disease patients.The aim of this article is to explore the influence of infliximab on postoperative complications in Crohn's disease patients.

Objective To investigate the clinical outcomes of patients with chronic hepatitis B and its influencing factors,and provide reference for the prognosis of patients with hepatitis B.Methods 102 patients with chronic hepatitis B from January 2009 to June 2014 were selected and divided into the case group of 32 patients and the control group of 70 patients according to whether to occur with cirrhosis or liver cancer.The two groups of patients were analyzed and compared for general information,HBV DNA,serum ALT and other indicators.Results The cumulative cases of negative HBsAg,chronical hepatitis B,liver cirrhosis and liver cancer were 5,65 and 32,respectively.Univariate Logistic regression analysis showed that the differences between the two groups in age,sex,drinking history,HBV DNA levels and serum ALT levels were statistically significant (all P ＜ 0.05).Whether to cirrhosis or liver cancer was the dependent variable,the statistically significant single factors between the two groups were the independent variable,multivariate Logistic regression analysis showed that older age,male sex,alcohol abuse,high level of HBV DNA and high level of serum ALT were the risk factors of leading to cirrhosis,liver cancer for the patients with chronic hepatitis B (OR values were 9.94,14.36,8.25,13.01,120.32,respectively).Conclusions The older age,male,alcohol history,high level of HBV DNA and high level of serum ALT are higher risk factors for patients with chronic hepatitis B to development of cirrhosis and liver cancer.Patients with risk factors should be gave systematic interventions to reduce progression to cirrhosis,liver cancer and improve the quality of life.

The virus is a common pathogeny in children,especially for infants and young children. The immuno-inflammation process for virus-induced sepsis is extremely complex. For different virus and dif-ferent target organs of invasion,the clinical features and evolution progresses are quite different. Specific and effective treatment measures are very limited. For virus-induced sepsis should pay high attention to it.

Proteolipid protein 1 (PLP1)-related disorders are a series rare X-linked recessive disorders caused by mutations of PLP1 gene.There is a spectrum of PLP1-related disorders from very severe connatal PelizaeusMerzbacher disease(PMD,MIM# 312080),through classical PMD to mild spastic paraplegia type 2 (SPG2,MIM# 312920),with some correlation between the type of mutation and the phenotype.The genotype of PLP1-related disorders was constantly discovered and updated,meanwhile there was obvious heterogeneous within clinical phenotypes.Moreover,there were so many diseases similar to PLP1-related disorders.Therefore,there was a huge challenge when clinician met with PLP1-related disorders.The aim of this report is to summarize correlation between the genotype and the phenotype of PLP1-related disorders,and give a help for clinician to diagnose this group complicated disorders.

As an important policy, the multiple-site physician practice system is expected to promote the flow of physicians and optimize the distribution of health resources, though it is difficult to enforce in practice. From the perspective of institutional change, the fundamental reason lies in path dependence existing in system, organization and mindset:First, the government regulation system has a strong inertia to restrict the flow of physicians, and the multiple-site physician practice lacks the unity of legitimacy and rationality. Secondly, fierce competition between hospitals and the distribution pattern of rights and responsibilities between hospital and physician cause the hospitals to oppose multiple-site physician practices. Third, the stability tendency in mind and the desires for profit restrain the flow of physicians. Therefore, the institutional change of the multiple-site physician practice requires improvements in three aspects:the innovation of government systems to unlock the multiple-site physician practice must be accelerated to realize the unity of legitimacy and rationality;a change is needed in the operation logic of hospitals to control the profit incentives and management of practices by contract;the thought-pattern of physicians must be changed to con-front the proper demand for interests and build innovative incentive mechanisms.

Objective To explore clinical haracteristics, diagnosis, treatment, prognosis and prevention of mental disorder induced by interferon.Methods Thirty cases of interferon treatment for chronic hepatitis were select-ed as research subjects.The psychotic symptoms of these patients induced by interferon were analysized by clinical statistics.Results The Self-Rating Depression Scale( SDS) and the Self-Rating Anxiety Scale( SAS) scores after treatment were (47.10 ±9.47) points and (43.00 ±10.34) points,these were higher than before treatment and the difference was statistically significant (t=8.39,7.66,all P<0.01).The incidence rates of the psychotic symptoms in this group of interferon-induced were 66.7%(20/30).The occurrence rates of headaches,insomnias,depres-sions,anxieties and personality changes were respectively 36.7%,30.0%,16.7%,10.0%,10.0%.Before and after treatment,the difference was statistically significant (χ2 =15.43,P<0.01).Conclusion The symptoms of mental disorder induced by interferon have high incidence rate and serious consequences,so early detection and early treat-mentcan contribute a better prognosis.

Objective] To explore professor Yu Jingmao's clinical experience in coordinating and treating pediatric disease with herbal paste. [Method] By fol owing the teacher clinic, the author summarizes professor Yu Jingmao's academic experience of treatment of children with chronic il ness with herbal paste, and for proven cases. [Result] Professor Yu Jingmao uses herbal paste for modulating pediatric intractable disease with curative effect. In his opinion, herbal paste treatment of pediatric diseases must be combined with disease and syndrome differentiation, and considered in accordance with seasonal conditions and the patient's individuality. Professor Yu considers that herbal paste formulations are suitable for children, and pays attention to regulating and nourishing to strengthen the body focused on harmony, reinforcing with elimination based on balance, protecting and tonifying the spleen and stomach based on enjoying oral application. [Conclusion] According to children's physiological and pathological characteristics, professor Yu Jingmao has rich experiences in using herbal paste for personalized syndrome differentiation treatment of pediatric diseases to strengthen body resistance and eliminate evil, regulate Yin and Yang, which is worth generalizing and applying.

Neutrophil gelatinase-associated lipocalin(NGAL) is a new member of lipid protein family,which is a kind of stable polypeptide firstly separated from neutrophils.As a new biomarker of acute kidney injury(AKI) for early clinical diagnosis.NGAL is less easily affected by factors such as the body itself,drugs or aspects outside kidney.The high levels of NGAL in the blood and urine can both predict AKI.Dynamic monitoring NGAL can assess the validity of clinical therapy and give reference to treatment of AKI.

Objective To establish a risk indicator evaluation system on ladder-typed coordination between man and machine.Methods Using Delphi method,40 experts were inquired by letters for two rounds,the risk indicators and weights on ladder-typed human-machine coordination were identified.Results A risk indicator evaluation system was formed by 5 first-level indicators,17 secondary indicators and 22 tertiary indicators.Conclusions This research has a high degree of participation and authority from experts with an excellent coordination,forming a risk indicator evaluation system on laddertyped coordination between man and machine,which can provide a standard principle on man-machine coordination measures for mechanical ventilation patients.