Job Accommodation of American is effective to ensure the equal employment of domestic disabilities. This paper introduced its legal basis, contents and procedures.

Objective To explore the value of electroneurophysiological detection in diagnosis of children progressive muscular dystrophy (PMD).Methods The clinical features and laboratory data were analyzed in 32 children with PMD ,and electromyography(EMG) and nerve conduction velocity(NCV) were performed.Parameters studied included spontaneous activity , duration and amplitude of motor unit potential(MUP),pattern of recruitment as strong contracting,sensory conduction velocity(SCV),motor conduction velocity(MCV), distal latency and distal amplitude. Results The abnormality rates of spontaneous potentials was 49.2% and 80.9% in tibialis anterior.The decrease of duration of MUP was 29.7%-62.4%.Amplitude of strong contracting was significantly decreased.There were different from those in normal children(P

China ; Health Education ; Health Knowledge, Attitudes, Practice ; Humans ; Occupational Diseases ; prevention & control ; Occupational Health ; Rural Population ; Sampling Studies ; Transients and Migrants

China ; Health Knowledge, Attitudes, Practice ; Humans ; Occupational Diseases ; prevention & control ; Occupational Exposure ; prevention & control ; Occupational Health ; statistics & numerical data ; Rural Population ; statistics & numerical data

Objective To study the individualized dose of warfarin in treating atrial fibrillation in elderly patients. Methods Forty-one elderly in-patients with atrial fibrillation were recruited.Warfarin was used tO start anti-coagulation therapy with the target INR value 1.6-2.5.The data of demographic variables,concomitant diseases,medications and laboratory values were collected,then correlated these factors with the maintenance dose of warfarin. Results Warfarin dose requirements were significantly associated with age(r=-0.535,P＜0.01),sex(r=-0.494,P＜0.01),height (r=0.484,P＜0.01),weight(r=0.453,P＜0.01),body surface area(r=0.388,P＜0.05),concomitant use of a sulfonylurea medication(r=-0.446,P＜0.01)and serum albumin level(r=0.520,P＜0.01).The multivariate regression model includedthe variables of age,sex,serum albumin level and concomitant use of a sulfonylurea medication.This algorithm explained 65.4%of the variance in the maintenance dose of warfarin(R=0.808,R2=65.4%). Conclusions The warfarin dose in treating atrial fibrillation in elderly patients can be estimated from demographic,clinical and laboratory factors that can be obtained at the time of warfarin initiation.

Accidents, Occupational ; prevention & control ; Emergency Medical Services ; organization & administration ; Humans ; Occupational Exposure ; prevention & control ; Occupational Health ; Poisoning ; prevention & control ; Risk Assessment

Acquired Immunodeficiency Syndrome ; drug therapy ; epidemiology ; Antiretroviral Therapy, Highly Active ; adverse effects ; methods ; China ; epidemiology ; Female ; HIV Infections ; drug therapy ; epidemiology ; Humans ; Male ; Minority Groups

Objective To estimate the biological effects of leptin on human HaCaT keratinocytes and explore their molecular mechanisms.Methods Cell counting kit-8 (CCK-8) was used to evaluate the proliferation of cultured HaCaT cells treated with different concentrations of leptin for 24 and 48 hours.Some HaCaT cells were classified into four groups to remain untreated,be treated with leptin (100 μg/L) and piceatannol (a specific inhibitor of STAT3 phosphorylation) alone or in combination for 24 hours,respectively,followed by the evaluation of cell proliferation using CCK-8 kit.Flow cytometry was performed to assess cell cycle of HaCaT cells treated with leptin of 100 μg/L,Western blot to determine the phosphorylation level of Erk1/2 and STAT3 in HaCaT cells treated with leptin of 100 μg/L for different durations.Statistical analysis was done by Student's t-test for unpaired data using GraphPad Prism 5 software.Results The proliferation of HaCaT cells was accelerated to different degrees after treatment with leptin of 50 and 100 μg/L for 24 and 48 hours,and the accelerating effect was in a dose-dependent manner within 24 hours (r =0.9989,P ＜ 0.05).Piceatannol apparently inhibited the promotive effect of leptin on the proliferation of HaCaT cells.There was an obvious elevation in the percentage of cells at S phase ((57.70 ± 5.88)％ vs.(42.50 ± 7.55)％,P ＞ 0.05),but a significant decrease in that at G0/G1 phase ((39.70 ± 1.57)％ vs.(45.20 ± 1.44)％,P ＜ 0.05),with a significant increase in proliferation index (0.603 ±0.0157 vs.0.564 ± 0.0144,P ＜ 0.05) in HaCaT cells treated with leptin of 100 μg/L for 24 hours compared with the untreated controls.Western blot showed that leptin of 100 μg/L markedly enhanced the phosphorylation level of STAT3 in HaCaT cells.Conclusion Leptin may upregulate the proliferation of HaCaT cells through activation of STAT3 pathway.

Objective To explore the impact of Microsurgical operation through lateral fissure-insula lobe approach in the treatment of hypertensive cerebral hemorrhage in basal ganglia region on the clinical curative effect.Methods Selected 90 cases of patients with hyper-tensive cerebral hemorrhage in basal ganglia region in our hospital from April 2013 to December 2015.According to the random number table method,they were divided into the observation group and the control group.Regarded the even numbers as the observation group while the odd numbers as the control group,with 45 cases in each group.Patients of the two groups were all performed general anaesthesia with tracheal in-tubation.And patients of the control group were given large trauma craniotomy,while patients of the observation group were treated by micro-surgical operation through lateral fissure-insula lobe approach.Recorded the situation of surgery and postoperative recovery of patients in the two groups.In addition,compared the postoperative complications and evaluated living conditions of the two groups through activity of daily living scale(ADL)half a year after surgery.Results The good rate of recovery in the observation group was 84.44% (38 /45),while it was 51.11%(23 /45)in the control group,and there was statistically significant difference between the two groups(χ2 =11.447,P =0.000).Be-sides,the mortality rate of the observation group was 0(0 /45)half a year after surgery,while it was 8.89%(4 /45)in the control group,and there was statistically significant difference between the two groups(χ2 =4.186,P =0.041).The operation time of observation group and the automatic opening time in the observation group were obviously shorter than that of the control group(P <0.05).Moreover,the hematoma clearance rate and GCS score of the observation group 1 week after operation were significantly higher than those of the control group (P <0.05).The incidence of postoperative complications of the observation group was 8.89%(4 /45),which was significantly lower than 31.11%(14 /45)in the control group,and there was significant difference(P <0.05).Conclusion It has many advantages such as shorter operative time,faster postoperative recovery,and higher hematoma clearance rate to apply microsurgical operation through lateral fissure-insula lobe approach in the treatment of hypertensive cerebral hemorrhage in basal ganglia region.Besides,it pays attention to protecting cerebral vascular of patients.The clinical treatment effect is ideal and safe.Therefore,it is worth popularizing in clinical application.

Objective To review the experience of perioperative management and effect of valve replacement combined with renal dysfunction.Methods 536 cases of valve replacement.According to preoperative glomerular filtration rate(GFR),renal dysfunction was classified as normal in 322 cases,mild in 162,moderate in 40 and severe in 12.Logistic regression analysis was used to assess the effect of preoperative renal dysfunction on operative mortality and morbidity.Results Patients with a lower GFR were older and more likely to have hypertention.They also tended to have larger left ventricular end-diastolic diameter and worse left ventricular ejection factor.Operative mortality rose inversely with declining renal function,from 2％ for those with normal renal function to 17％ for patients with severe renal dysfunction.Renal dysfunction was significantly associated with a large blood transfusions,re-intubation,longer mechanical ventilation,intensive care unit stay and hospital stay.Conclusion Preoperative renal dysfunction is an important factor of postoperative mortality and morbidity for valve replacement.We must pay more attention to perioperative management.