Objective To explore the application effect of the wechat public platform in follow-up management of patients with moderate or severe craniocerebral injury.Methods 98 patients admitted in the craniocerebral department of our hospital from February to November 2014 were selected and divided into two groups by random number table method,with 48 cases in the control group and 50 cases in the observation group;the traditional follow-up management mode using telephone was adopted to patients in the control group,while the follow-up management mode using the wechat public platform was adopted to those in the observation group,with a follow-up period of 3 months;for patients in both groups,their activities of daily living (ADL) and exercise of self-care agency (ESCA) abilities before and after intervention,occurrence of adverse events and complications within the follow-up period,and their degree of satisfaction towards the follow-up management were collected.Results After intervention,ADL score,total scores of ESCA and total scores of satisfaction towards the follow-up management among patients in the observation group were 87.34±15.26,24.36±17.24 and 86.07±14.82,which were significantly higher than that among patients in the control group were 66.72±14.62,99.37±15.29 and 61.14±13.19 (t=7.941,7.982,6.962,all P ＜0.01);within intervention,the observation group had significantly lower total occurrence rate of adverse events and complications which was16.00％ (8/50) compared to the control group 39.58％ (19/48) (x2=6.824,P ＜ 0.01).Conclusions By establishing the follow-up management mode for patients with craniocrerbral injury through the wechat public platform,effect of the follow-up management can be effectively promoted,prognosis of patients can be improved and patients' degree of satisfaction can be enhanced;it is worth of being further promoted clinically.

Objective: To study the cognitive function of patients with myasthenia gravis.Methods: Cognitive function of 35 patients with general myasthenia gravis and 31 patients with Eye-Muscles myasthenia gravis,and 35 control subjects was examined with cognitive measures of Recall of Auditory Verbal Learning Test,Symbol Digit Modalities Test,Trail Making Test,Logic Memory Test,Stroop Color Words Test(A、B 、C),Verbal fluency Test and Boston Naming Test.Results: MG patients performed worse than the control subjects on several cognitive measures.Conclusion: There is disorder of cognitive function in the patients with myasthenia gravis,revealing that there may exist deficiency in the central neuroal system of the patients with myasthenia gravis.

Objective\ To evaluate the efficacy of atrial lead implantation during atrial fibrillation.Methods\ In 10 patients(group A),the atrial leads were implanted during atrial fibrillation and the sensing and pacing parameters before and after restoring to sinus rhythm were compared with the parameters of patients whose atrial leads were implanted during sinus rhythm (group B).Results\ During follow-up,the sensing and pacing parameters were measured,and there were no significant difference between group A and B.In group A,mean atrial potential amplitude during atrial fibrillation was correlated with the telemetered atrial potential amplitude during sinus rhythm.Conclusion\ Atrial lead implantation during atrial fibrillation is feasible.

Objective To compare the effect of endoscopic ultrasonography (EUS),magnetic resonance chlangiopancreatography (MRCP) and endoscopic retrograde cholangiography (ERCP) in the diagnosis of suspicious intermediate choledocholithiasis.Methods One hundred and eighty-six patients with suspicious intermediate of choledocholithiasis successively received MRCP,EUS,and ERCP examination.The stone taking out by endoscopic as diagnositic standard,and the sensitivity,specificity and accuracy in different methods was compared.Results Sensitivity and accuracy of EUS was significantly higher than that of MRCP [97.5％(155/159) vs.92.5％(147/159),97.3％(181/186) vs.91.9％(171/186)](x2 =4.21,5.30,P =0.04,0.02).There was no statistically significant difference between EUS and ERCP in specificity [96.3％(26/27) vs.88.9％ (24/27)] (x2 =115.40,P ＜ 0.05).Sensitivity,specificity and accuracy of ERCP was 98.9％(184/186),98.7％(157/159) and 100.0％(27/27),and there was no difference between EUS and ERCP in the diagnosis of choledocholithiasis (P ＞ 0.05).Conclusions EUS is similar with ERCP for the diagnosis of choledocholithiasis.By performing EUS or MRCP first,ERCP may be avoided in patients with suspicious intermediate choledocholithiasis.

Objective To evaluate the risk factors for prognosis in liver cirrhotic patients with acute esophageal variceal bleeding (EVB). Methods Retrospective analysis was carried out in patients with liver cirrhosis,who were admitted to the hospital for EVB between January 2000 and December 2006 . All patients were follow-up to August 31st, 2009. The death of the patients was identified as the end of the study. The vital signs and results of laboratory tests were recorded when patients were admitted to the hospital. Child-Pugh score/grade, model for end stage liver disease (MELD) score and Rockall score were calculated. Results Ninty-five cases (66 males and 29 females) were enrolled in the study. Among them, 60 cases died and 35 cases survived for (42. 61±33.21) months (ranged from 2 days to 114 months). Univariate Cox regression analysis showed that age, male, Child-Pugh score/grade, MELD score, Rockall score, white blood cell counts and active hepatitis B were risk factors for death in liver cirrhotic patients with EVB (P＜0.05), while high level of hemoglobin and high hematocrit, endoscopic variceal sclerosis therapy or surgical treatment were protective factors (P＜0.05). Multivariate Cox regression analysis revealed that Child-Pugh grade (RR= 4. 997,95%CI:2. 787～8. 960, P＜0.01),Rockall score (RR= 1. 284,95%CI:1. 062～1. 553,P=0. 010), high counts of white blood cells (RR= 1. 072,95%CI: 1. 001 ～ 1. 148, P= 0. 046) were risk factors for prognosis of liver cirrhotic patients with EVB. Conclusion It is demonstrated that Child-Pugh grade,Rockall score and high counts of white blood cells are risk factors for prognosis of liver cirrhotic patients with EVB.

Objective To investigate the percentage of CD4 + C125 +Tregs in peripheral blood of patients with sepsis and its effect on cell immunity so as to unravel the effect of immunomodulatory therapy on it. Method Fourty patients with sepsis in ICU were randomly (random number) divided into experimental group and control group . The patients of experimental group were treated with Ulinastatin and immunoregulation agent (Thymosin αl) as well. The blood specimens were collected just before treatment, 3 days and 8 days after treatment. The percentages of CD4 + CD25 + Tregs and lymphocyte subsets were detected by using FCM (flow cytometry), and TNF-α, IL-6 and IL-10 assayed by using ELISA, and APACHE Ⅱ scores were calculated. Results Before treatment, the percentage of CD4 + CD25 + Tregs increased, and the number of lymphocytes and the percentage of T lymphocytes decreased, especially the CD4 + T lymphocytes and CD4+/CD8+ decreased more markedly, and the levels of IL-6 and TNF-α increased. After treatment,the percentage of CD4+ CD25 + Tregs was decreased, the number of lymphocytes and CD4 +/CD8 + increased, and the levels of APACHE Ⅱ score, IL-6 and TNF-α decreased especially in the experimental group decreased more significantly (P ＜ 0. 05). Conclusions The percentage of CD4 + CD25+ Tregs in peripheral blood can reflect the immune status of patients with sepsis and become a novel indicator to estimate the progress of sepsis, and the immunity and prognosis of patients. Treating the patients with Thymosin αl and Ulinastatin can raise their immunity, decrease the levels of IL-6, TNF-α and APACHE Ⅱ score and improve their prognosis.

Objective To compare the effect of Baikerui compound lysostaphin (FE complex phosphoesterasum) disinfectant and povidone iodine in treatment of burn wound infection resulted from gram-positive (G ±) coccus.Methods The study involved 60 patients with superficial second degree burns (1％-5％ TBSA； age range of 18-50 years).All the patients received bacterial culturing of wound secretions prior to treatment.Every 20 patients were indentified with infection of staphylococcus aureus (SA),staphylococcus epidermidis (SE),and enterococcus (EC) respectively and randomized into control group and experiment group,with 10 patients per group.Patients allocated to the experiment group were covered with four-layer sterile gauze soaked into the Baikerui compound lysostaphin disinfectant,while the patients in the control group were treated with four-layer sterile gauze soaked into the povidone iodine.Dressing was changed once a day.Wound culturing was performed again at each day of the 5-day treatment.Wound healing was compared among each group.Results SA wound infection turned negative for all the 10 patients in experimental group and three patients in control group (P ＜ 0.01).SE wound infection turned negative for all the 10 patients in experimental group and six patients in control group (P ＜ 0.05).EC wound infection turned negative for nine patients in experimental group and seven patients in control group (P ＞ 0.05).Mean wound healing time was (10.87 ± 1.93) days for experimental group and (13.31 ± 2.89) days for control group (P ＜ 0.05).Conclusion Baikerui compound lysostaphin disinfectant can effectively prevent burn wound infection with common G + coccus and accelerate wound healing.

Objective To explore the experience of nursing patients with Crohn’s disease.Method The nursing histories of 80 patients with Crohn’s disease were retrospectively reviewed to analyze and summarize the measures for nursing them.Result After active treatment and effective nursing,all the patients were improved and discharged.Conclusion Effective nursing is of positive significance to improve the curative effect of Crohn's disease.

Background and purpose: Langerhans cell histiocytosis (LCH) is a rare complex reticulocndotheliai disease that often invades the head and neck. There in no consensus of treatment. Radiation is one of the treatment options for the localized lesions. Our aim in the study was to analyze the radiotherapeutic efficacy for LCH in the head and neck region. Methods: 8 patients with eosinophilic granuloma (EG) and 1 case with Hand-Schuller-Christian disease (HSC) were treated with radiotherapy in our hospital from July 2000 to May 2007. Their clinical data were retrospectively analyzed. Results: 5 cases of EG were treated with tumor partial excision and radiation, while the other 3 cases of EG were given radiation alone after biopsy. The HSC was administered with radiation and endocrine therapy. All the patients were followed up for 1.5-8 years. The response rate was 89%. Conclusion: Radiotherapy of LCH is an effective modality, but the optimal dose needs to be further studied.

The herpes simplex virus type 1 (HSV-1) VP22, is one of the most abundant HSV-1 tegument proteins with an average stoichiometry of 2 400 copies per virion and conserved among alphaherpesvirinae. Many functions are attributed to VP22, including nuclear localization, chromatin binding, microtubule binding, induction of microtubule reorganization, intercellular transport, interaction with cellular proteins, such as template activating factor I (TAF-I) and nonmuscle myosin II A (NMIIA), and viral proteins including tegument protein VP16, pUS9 and pUL46, glycoprotein E (gE) and gD. Recently, many novel functions performed by the HSV-1 VP22 protein have been shown, including promotion of protein synthesis at late times in infection, accumulation of a subset of viral mRNAs at early times in infection and possible transcriptional regulation function.