Tourette syndrome is a neuropsychiatric disorder characterized by the presence of both multiple motor and vocal tics. The pathogenesis is obscure . Infection and the immunologic abnormality after infection may be associated with this disease.The major study is about streptococcal infection. Interleukin may play an important role. Morever, some studies indicate that Mycoplasma pneumoniae infection is related to the Tourette syndrome.

Objective To learn the burnout and turnover intention of physicians from township hospitals in Xi County,Henan province,for reference of health administrators and healthcare institution managers.Methods Cluster sampling method and qualitative interviews were used and all physicians from such hospitals were sampled for questionnaire survey in 2014,with 1 70 scales distributed.The questionnaire was the Markov Burnout Inventory generic version revised by Li Chaoping,and turnover intention questionnaire was that revised by Liang Kaiguang.Results 140 physicians from such hospitals were found with zero or low burnout (94.6%);Collaborative care in the county poses great positive effect on promoting professionalism and interpersonal relations, yet has limited positive impact on reducing workload and performance appraisal stress and increasing their income.Conclusion It is imperative to enhance training of managers of such hospitals for them to learn the appraisal method with organizational scale,and build a humanistic concern mechanism for physicians,for purposes of improving the organizational environment and minimize the burnout and turnover intention of the physicians.

Diagnosis related groups (DRGs)have been widely used in many countries and regions.The versions of DRGs in different regions are modified according to the local circumstances and conditions.Beijing version DRGs (BJ-DRGs)is the first DRGs system in Chinese,which was developed locally based on the conditions of medical information system and health relative policies in Beijing.This paper introduced the grouping principles,logic and methodology of BJ-DRGs.Taking“ear,nose,mouth and throat disorders”for example,this paper demonstrated the grouping process of BJ-DRGs.

Acupuncture Therapy ; Adolescent ; Adult ; Aged ; Chronic Disease ; therapy ; Female ; Humans ; Male ; Middle Aged ; Pterygopalatine Fossa ; innervation ; Rhinitis ; physiopathology ; therapy ; Smell ; Treatment Outcome ; Young Adult

Adult ; Aneurysm, Dissecting ; Humans ; Male ; Pulmonary Artery

Digestive tract reconstruction after proctocolectomy is a critical step of colorectal surgery, proper reconstruction can promote the recovery of digestive tract function and improve the quality of life.At present, there are some candidate reconstruction methods after proctocolectomy, but standardized and proper one is not still established.Since there are differences of the reconstruction methods after proctocolectomy at the different parts of colorectum, the best reconstruction methords should be selected according to the condition and intraoperative situation of patients.

Objective To study the clinical feasibility and effect of totally endoscopic resection of axillary accessory breast.Methods Totally endoscopic resection of axillary accessory breast was performed in 48 cases(59 sites).On the basis of liposuction,a camera port and two 5-mm working trocars were made.By using forceps,dissecting scissors,or harmonic knife,were inserted.The cobweb-like fibropartition around the accessory breast was dissected.Results Postoperatively,there were 1 case of subcutaneous liquid accumulation and 2 cases of subcutaneous petechia,and no hematoma or infection developed.All wounds healed by first intention.Follow-up observations for 2～58 months(mean,23.6 months) showed good appearance and satisfactory effects.Conclusions Totally endoscopic resection of axillary accessory breast is safe,offering good cosmetic effects and being worthy of recommendation.

Objective To investigate the effect of muscle fatigue on linear and nonlinear dynamics of sEMG from biceps brachii during maximal voluntary isometric contractions.Method Ten young volunteers subjects performed non-fatiguing isometric contractions with four load levels and fatiguing maximal voluntary isometric contractions.Linear and nonlinear analysis were used to examine the sEMG signals and the changes of sEMG signals when MVC decreased to levels of 80% MVC,70% MVC,60%MVC and 50%MVC compared with the signals of sEMG during non-fatiguing contractions.Result Statistical analyses revealed that AEMG and %DET were significantly higher at fatigue states than those at non fatigue states,while MPF and C(n)were significantly lower than those at non fatigue states.With the development of muscle fatigue,MPF and %DET significantly decreased during maximal effort,while AEMG and %DET stayed stable.The interaction of load level and fatigue state for AEMG,MPF and C(n)were significant.Conclusion MPF and C(n)significantly decrease during maximal voluntary isometric contractions.sEMG dynamics between fatigue state and non-fatigue state is significantly different.

blank group. Conclusion Fangshi capsule combining with Auricular-plaster therapy could prevent the formation of cholesterol gallstone possibly by reducing the calcium ion concentration in the bile.

Objective To improve the diagnosis and treatment for malignant adrenal tumors. Methods Clinical data of 50 cases of malignant adrenal tumors were retrospectively analyzed.Of them 7 cases of corticoadrenal carcinoma with endocrine function presented with relevant symptoms and endocrine abnormality.Among 23 cases of malignant pheochromocytoma high blood pressure existed in 19 and 18 had a high level of urinary catecholamine.Fifteen cases had corticoadrenal carcinoma without endocrine function and 5 cases developed adrenal metastic carcinoma.All of the patients underwent endocrinological and image examination before operation. Results Among the 27 cases of corticoadrenal carcinoma or metastasis,25 were confirmed by pathology and 2 were confirmed during follow-up.Of the 23 patients who were diagnosed as malignant pheochromocytoma,11 were confirmed to have extensive tumorous infiltration or metastasis by imaging procedures and operations and 12 were detected by follow-up to have metastasis.Tumors were resected in 14 cases of corticoadrenal carcinoma,8 of whom survived for 1～5 years.Twelve cases of malignant pheochromocytoma underwent radical operations with a survival of 1～14 years. Conclusions Most cases of corticoadrenal carcinoma can be diagnosed by pathology or image findings of metastasis.Pheochromocytoma is more likely to be malignant when it recurs,expecially for the extro-adrenal pheochromocytoma.The diagnosis of malignant pheochromocytoma must depend on the evidence of tumorous infiltration or invasion of the tissue without para ganglions found by imaging procedures or pathology.The prognosis of the late-stage corticoadrenal carcinoma is poor.For the cases of late-stage malignant pheochromocytoma dibenzyline or 131 I-MIBG treatment can extend their lives.