Characterized by chronic arthritis, juvenile idiopathic arthritis (JIA) refers to a group of rheumatic diseases in children with unknown causes and strong clinical heterogeneity.Most patients have good prognosis, while some may be involved with important extra-articular organs and tissues, including cardiac system damage, pulmonary or pleural lesions, renal amyloid degeneration, uveitis, and so on.Delay in diagnosis and treatment may lead to short-term and/or long-term involvement in vital systems, thus resulting in the aggravation of the disease or poor prognosis, which may decrease their life quality and even threaten their life.Understanding the extra-articular manifestations of JIA is very important to manage disease.

Rheumatoid arthritis ( RA ) and systemic lupus erythematosus ( SLE ) are the most important and typical autoimmune diseases,however their exact mechanisms has not yet been clear. Autohpagy,a highly conserved process,depends on catabolism of lysosomal degradation of macromolecules or organelles within the cell itself. Autophagy exists widely in various tissues and is involved in maintaining survival and differentiation of cell or the stablility of internal environment. Recently,autophagy has gained wider attention and been one of the hot points of relative reserches. In this review we′ll sum up the development of autophagy in RA and SLE.

Objective To investigate the expression of aquaporin-4 (AQP4) in contused brain and contralateral side and correlation of AQP4 level with brain edema.Methods A total of 70 health adult SD rats were divided into sham operation group (n =10) and brain contusion group (n =60) according to the random number table.Except for no impact in sham operation group,the remaining operations were the same in both groups.Ten rats in brain contusion group were separately sacrificed at 1,6,24,48 and 72 hours,and 7 days.Pathological changes in brain tissues of rats were detected and immunohistochemistry staining and Western-blot were used to measure AQP-4 expression.Results There were no abnormalities of brain tissue structure in sham operation group with AQP4 expressed mainly in glial cells and vascular endothelial cells.With respect to the injured side in brain contusion group,mixed brain edema that consisted of angioedema and cellular edema occurred along with tissue necrosis,massive inflammatory cell infiltration,and microgial proliferation.AQP4 was apparently expressed in gliocytes and vascular endothelial cells,which showed a fall at 1 hour,the lowest at 6 hours,the peak at 24 hours,slow fall at 48 hours,a second peak at 72 hours,and then a fall until 7 days.Level of AQP4 other than that at 1 hour had significant difference compared with sham operation group (P ＜ 0.01).Whereas the contralateral side in brain contusion group showed no pathological abnormalities at 1 hour,but cellular edema emerged at 6 hours followed by mixed brain edema mainly characterized as cellular edema at 24 hours,continued cellular edema but alleviated angioedema at 48 and 72 hours,and alleviated cellular edema at day 7.AQP4 was up-regulated in gliocytes and vascular endothelial cells,which decreased at 1 hour (1.313 ± 0.01),minimized at 6 hours (0.922 ± 0.03),peaked at 24 hours (2.848 ± 0.020),fell at 48 hours,peaked again at 72 hours (2.662 ± 0.02) and fell to almost normal level at day 7.By contrast with sham operation group,level of AQP4 had significant difference other than that at 1 hour and 7 days (P ＜ 0.01).Conclusions After brain contusion,angioedema and subsequent cellular edema emerge in the contused side.Pathological changes are delayed in non-contused side with cellular edema ahead of angioedema.Level of AQP4 is closely related with traumatic brain edema.

Objective To study the curative effect of anterior cervical discectomy with fusion (ACDF)and anterior cervical corpectomy with fusion (ACCF)for multi segment cervical spondylosis;and to provide effective anterior surgery for the disease.Methods According to digital table,106 cases with multi segment cervical spondylosis were randomly divided into ACCF group of 54 cases and ACDF group of 52 cases.The ACDF group was treated with ACDF,and the ACCF group was treated with ACCF.The operation time,bleeding volume and excellent rate of cervical functional improvement of the two groups were observed,and the bone graft fusion,cervical vertebra height change and the change of cervical curvature of the two groups were evaluated.Results The operation time of the ACDF group was higher than that of the ACCF group,the amount of bleeding of the ACCF group was lower than that of the ACDF group,and the differences werestatistically significant (t =2.857,9.097,all P <0.05 ).After 6 months and 12 months,the segments of the ACDF group were higher than those of the ACCF group,the differences were statistically significant (t =8.157,6.330,all P <0.05).After 6 months and 12 months,the section curvature increases and cervical vertebra increased curvature of the ACDF group were lower than those of the ACCF group,the differences were statistically significant (t =4.707,4.575,4.083,3.987,all P <0.05).The complication rate of the ACDF group was 11.5%(6 /52),which of the ACCF group was 13.0%(7 /54),the difference was not statistically significant (χ2 =0.050, P >0.05).Conclusion For multi segment cervical spondylosis,there are no significant differences in efficacy and stability between ACDF and ACCF;ACCF surgery field is more clear and easy to operate,the operation time is short, and there is the phenomenon of titanium mesh sinking.In the maintenance of cervical curvature,ACCF is better than ACDF.

Objective To compare the effects of surgical versus non-surgical treatment for femoral neck fractures in elderly patients,in order to provide guidance on treatment options.Methods The clinical effects and complications of different approaches from 42 patients with femoral neck fractures who had received treatment at our department from February 2006 to August 2011 were retrospectively analyzed.Results Of the 42 cases,13 cases were treated with artificial hip replacement,18 cases with hollow lag screw fixation,and 11 cases with tibial traction.No death occurred in patients treated with surgery,and 4 patients who had received non-surgical treatment died within 6 months of the followed-up.Conclusions Very elderly patients with femoral neck fractures generally perform well under appropriate perioperative care.Surgical treatment can produce good therapeutic effects,shorten the time for bed rest,improve the quality of life and reduce the mortality rate.

To compare the effects of immune enhancement, anti-fatigue and anoxia tolerance on mice of four kinds of dodder seeds in Shandong Province.

Objective To discuss the cause and treatment strategy for open laryngotracheal trauma.Methods The clinical data of 38 cases with open laryngotracheal trauma admitted from 1998 to 2012 were collected and analyzed.Of them,one patient died in emergency department despite energetic resuscitation,37 were hospitalized and given advanced treatment after life support measures in emergency department.They were treated with tracheotomy before or during operation.Of them,32 patients were regularly followed up for imaging studies.Result Except 1 patient died of exsanguination from carotid artery rupture,the other 37 survived after successful treatment.Twenty patients were treated with debridement and suture of the wounds and laryngoplasty (20/37,54.1％),8 patients were operated with laryngoplasty plus intraluminal stents implanted (8/37,21.6％) ; the rest 9 patients (9/37,24.3％) were separately given placement of nickel-titanium shape memory alloy stent (n =2),laryngofissure with rubber gloves throat models implanted and laryngoplasty (n =3),linear silicone tube implanted and laryngoplasty with trans-cervical approach (n =1) and tracheoesophageal fistula neoplasty with laryngoplasty and laryngofissure (n =3).The operated patients were followed-up for 0.5 to 3 years after discharge.Of them,35 patients (35/37,94.6％) had successful decannulation,breathing smoothly and swallowing normally,23 patients (23/37,62.2％) had almost normal pronunciation,12 patients (12/37,32.4％) had different degrees in hoarseness of voice,and 2 patients (2/37,5.4％) were referred to other hospital because of failure in extubation with severe stenosis of laryngotrachea.Conclusions When the patients with open laryngotracheal trauma were treated,the essential strategy was to prevent shock,hemorrhage,and asphyxia.In the case of patent respiratory tract and stable vital signs,laryngotracheal reconstruction should be carried out as soon as possible to prevent complications,thereby obtaining good therapeutic effect.

Migrant workers incur the challenges of linkage and compatibility of medical insurance systems for their migration across regions and change of identities. To identify a medical insurance system adaptable to their needs, the paper recommends the following: Take their medical insurance into the national account of medical insurance; build a linkage mechanism between cities and villages, and that between cities as well; make the medical insurance system more compatible and portable, in order to safeguard their right of health.

OBJECTIVE To investigate the clinical distribution and drug resistance of clinical Pseudomonas aerugilosa isolates,and offer reasonable experimental data for clinical therapy.METHODS P.aerugilosa was identified by ATB Expression system,and its drug resistance was determined by Kirby-bauer and ATB Expression method.RESULTS The main departments in which frequently P.aerugilosa infection accurred were Intensive Care Unit(41.2%) and Respiration Departments(19.3%).The common site of P.aerugilosa infection was respiratory tract(68.2%).The sensitive rate of P.aerugilosa to polymyxin E and cefoperazone/sulbactam was the highest(95.1% and 91.4%),while to meropenem and imipenem was 77.5% and 70.6%.The highest resistant rate of P.aerugilosa to trimethoprim/sulfamethoxazole,ampicillin/sulbactam was 97.1% and 95.1%.The resistunce to ciprofloxacin,ticarcillin and piperacillin,were 64.9%,63.3% and 56.3%.CONCLUSIONS P.aeruginosa is major pathoge in our hospital.It is important to select antibiotics correctly according to the results of susceptibility tests.

Objective To analyze reason and countermeasures of unqualified blood specimens ,improve the qualified rate of sam-ples ,to strengthen the quality control before analysis .Methods A retrospective statistical analysis were conducted to analyze the characteristics of the unqualified specimen and reasons from January 2013 to June 2014 .Results A total of 11 024 unqualified spec-imens accepted in the inspection center from January 2013 to June 2014 ,accounting for 0 .331% of reasons of unqualified specimens including hemolysis(26 .7% ) ,blood coagulation(25 .8% ) .The unqualified specimen in surgical system was higher than that in med-ical system .Conclusion Control specimen qualified rate system should be established in clinical laboratory ,the fraction defective samples should be reduced through continuous analysis and communication with clinical medical personnel to ensure the quality be-fore analyzing .