Objective: To investigate the clinical and familial characteristics of essential tremor(ET).Methods: The clinical features and familial history of 2 ET patients were reviewed.Results: The clinical manifestation of the probands was intentional tremor,which could be ameliorated by alcohol.The incidence of the disease was 55.6% and 43.7% among the first-and second-degree relatives of the two families.Propranolol,a ?-adrenoceptor antagonist,was an effective drug for ET.Conclusion: Clinically ET is characterized by postural or intentional tremor,which mostly involves the hands and head.Positive result of the alcohol test is shown in most ET patients.It is commonly assumed to be a genetic disease.

Objective To investigate the possible role of mycobacterial infection in the pathogenesis of sarcoidosis.Methods DNA fragments of mycobacterial16S rRNA gene and the complex-specific insertion sequence IS6110of M.tuberculosis were detected by polymerase chain reaction(PCR)in formalin-fixed,paraffin-embeded skin biopsy specimens from12patients with sarcoidosis.Results Mycobacterial common sequence16S rRNA gene was found in6patients,among which5were further confirmed as M.tuberculosis,the other one was atypical mycobacteria.The IS6110DNA fragment amplified by PCR was confirmed by DNA sequencing.Conclusion The above findings suggest an aetiological role of mycobacterial infection,especially M.tuberculosis,in some patients with sarcoidosis.

Autophagy and apoptosis are two kinds of important ways of neuronal death in cerebral ischemia.The interaction of both in ischemic penumbra may alleviate or aggravate cerebral ischemic injury.This article reviews the role of autophagy and apoptosis in cerebral ischemia and their potential regulating mechanisms of interaction.

Objective To analyze and compare the effect of early minimally invasive surgical treatment and conventional treatment for patients with severe acute pancreatitis.Methods According to the including criteria,eight randomized-controlled trials of this topic were enrolled into the analysis.The detail about the trial design,characters of the subjects and results of the studies were reviewed and analyzed by using Revman 4.2 software.Results Compared with conventional treatment,early minimally invasive surgical treatment was associated with a significantly lower incidence of mortality(RR=0.35,95%CI:0.20～0.63,P

OBJECTIVE: To evaluate the effect of Eucommiae ulmoides on the microstructural and ultrastructural change of femur and lumber vertebrae in ovariectomized rats.METHODS: 80 4-month-old female SD rats were randomized to 4 groups: sham operation group,model group,alfacalcidol group,E.ulmoides group.In the sham operation group,the abdominal cavities of the rats were cut open to expose ovaries before being sutured.However,the rats in the other 3 groups were ovariectomized bilaterally.At 10 days after operation the rats were administered intragastrically with corresponding drug.After 3 months,femur and lumber vertebrae were dissected and fixed in 4% glutaral for 3 days,then decalcified in 4% EDTA for 4 weeks,and then the structure of femur and lumber vertebrae was observed under light microscope and transmission electron microscope(TEM).RESULTS: Observed under light microscope,the femur and lumber vertebrae were full of fat in the ovariectomized rats and in which the density of bone trabecula decreased significantly;however,in alfacalcidol-treated rats and E.ulmoides-treated rats,the amount of fat decreased markedly while the density and thickness of bone trabecula increased.Observed under TEM,in the ovariectomized rats,rough endoplasmic reticulum(RER),cytolysosome and mitochondrial were plentiful inside osteoclasts in femur and lumber vertebrae,partial osteoblasts atrophied,the amount of RER and other cellular organ decreased significantly and apoptosis appeared for partial cells;however,in alfacalcidol-treated group and E.ulmoicdes-treated group,the above changes improved significantly.CONCLUSION:E.ulmoides has remarkable beneficial effect on osteoporosis in ovariectomized rats.The mechanism might be attributed to its inhibition on the synthesis of fat and the activity of osteoclasts,promotion on the activity of osteoblasts and inhibition on the apoptosis.

Objective To investigate the factors of influencing plasma glucose level in STZ induced mice with chronic stress. Method We selected forty STZ mice and twenty normal Kun-ming(KM) mice, matched them with plasma glucose.Then the mice were divided into four groups:group A(STZ induced mice plus stress),group B(STZ induced mice),group C(stressing normal mice) and group D(normal mice).Stress factors were restraint, rotation and crowding. Their plasma glucose levels were determined every two weeks during the experiment. The contents of plasma insulin ,?-endorphin(?-EP) and Neuropeptide Y(NPY) in hypothalamus were measured after 6 weeks.Results After the chronic stress, in STZ mice(group A),the levels of plasma glucose and NPY were elevated significantly, the level of plasma insulin were gradually elevaled according to groups A,B,C,D,in sequences,there was obviously differences among the four groups significantly, ?-EP level increased according groups D,C,B and A slightly. Correlation analyses showed that there was negative correlation between the levels of plasma insulin and glucose(r=-0 4555,p

Objective To study the clinical value of exposure of recurrent laryngeal nerve in thyroid operation for the prevention of recurrent laryngeal nerve injury. Methods A total of 90 patients received thyroid operation in our hospital from April 2012 to August 2014 were enrolled and randomly divided into observation group(n=45) and control group(n=45) according to whether the recurrent laryngeal nerve were exposed during operation. The patients in observation group received thyroid operation with recurrent laryngeal nerve exposure, and the patients in control group received conventional thyroid operation. Then recurrent laryngeal nerve injury situation and operation situa-tion were compared. Results Recurrent laryngeal nerve injury symptoms were less in the observation group (2. 22%) compared with that of the control group (15. 56%) with a statistically singnificant difference(P<0. 05). The operation time of observation group (54. 45 ± 6. 62) min was longer than that of the control group (41. 29 ± 5. 82) min with a statistically singnificant difference (P<0. 05). The recovery time of observation group (5. 85 ± 0. 85) d was shorter than that of the control group (8. 02 ± 1. 12) d, with a statistically singnificant differ-ence (P<0. 05). There was no significant difference in bleeding volume during operation,postoperative drainage volume and drainage dura-tion between two groups(P>0. 05). Conclusion Exposure of recurrent laryngeal nerve in thyroid operation is helpful to prevent recurrent laryngeal nerve injury,which reduce the damage recovery time,although it will extend the operation time,does not increase bleeding and drainage volume.

Through the literature combing the interest groups of hospital information disclosure in the United States, the demand and practice of the main interest groups are analyzed. This paper uses policy maker4. 0 software to further analyze the interests of various interest groups, power and the degree of influence by the policy of hospital information disclosure. The results showed that interest groups involved in hospital information disclosure in the Unit-ed States can be mainly divided into five categories:consumers, employers, health insurance companies, hospitals, and decision makers ( government) . In order to balance the cost-effectiveness of various insurance schemes, health insurance companies choose high-quality service providers to restrict poor-service providers and insurers, and hospi-tals need to use public information to manage and improve health care. In order to monitor and improve the quality of medical services, employers need to weigh various insurance plans, health insurance companies have to measure the service quality of themselves and competitors, and hospitals need to manage and improve the medical quality and in-crease market share. As the largest stake in the hospital information disclosure, the results show that the consumer's position on the hospital information disclosure is low support. From the consumer as a main, although the hospital in-formation disclosure practices but the right to speak and other small powers have a limited participation. Analyzing the of the interest groups of hospital information disclosure in the United States, they all push forward the hospital infor-mation disclosure work to provide evidence to support.

Objective:To explore and observe therapeutic effect of nursing exercise rehabilitation on home patients with chronic heart disease (CHF) .Methods :A total of 122 CHF patients ,who performed home‐rehabilitation in community from Jan 2012 to Feb 2015 ,were selected .According to sealed envelope extraction method ,patients were randomly and equally divided into routine nursing group (received routine nursing intervention ) and exercise intervention group (received early exercise intervention based on routine nursing group ) ,the intervention period was eight weeks for both groups .The 6min walking distance (6MWD) ,left ventricular ejection fraction (LVEF) ,scores of Minnesota living with heart failure questionnaire (MLHFQ) and self‐behavior management scale were measured and compared between two groups before and after nursing .Results:Compared with before nursing ,after nursing , there were significant rise in 6MWD ,LVEF and score of self‐behavior management in both groups , P<0.01 all . Compared with routine nursing group after nursing ,there were significant rise in 6MWD [ (482.44 ± 65.29) m vs . (546.24 ± 76.13) m] ,LVEF [ (35.69 ± 7.22)% vs .(38.83 ± 6.92)% ] and score of self‐behavior management [(89.19 ± 25.14) scores vs .(103.49 ± 22.44) scores] ,significant reductions in physical [(62.12 ± 17.97) scores vs . (42.32 ± 17.67) scores] ,emotional [ (67.76 ± 17.17) scores vs .(51.32 ± 16.41) scores] and social dimension score [ (72.43 ± 10.31) scores vs .(62.44 ± 10.45) scores] of MLHFQ in exercise intervention group ,P<0.01 all .Con‐clusion:Nursing exercise can significantly enhance heart function and athletic ability ,improve self‐care capacity , help to improve quality of life in home patients with chronic heart failure .

Congenital hypertrophic pyloric stenosis(CHPS)is a common gastrointestinal congenital mal-formation in neonate and small infants.Pyloromyotomy is an effective method for treatment of CHPS,including several methods.Traditional open pyloromyotomy for the patient's body injury is serious,such as accident of an-esthesia,postoperative infection,skin scar;laparoscopic pyloromyotomy can cause the pylorus muscle incision uncomplete,invasive operation damage,etc.Endoscopic pyloromyotomy for neonatal has some advantages:a lit-tle injury,no scars,simple operation,less complications,quicker recovery of feeding.Endoscopic mucosal pyloro-myotomy may be a new method of treatment,needing further exploration and research.