Objective To analyze the clinical feature of 17 cases children toxic hepatitis type of mushroom poisoning ,investigate toxic hepatitis type mushroom poisoning treatment .Methods 17 children with mushroom poi-soning toxic hepatitis were chosen as the objects of study ,who were retrospectively analyzed .Results 17 cases of tox-ic hepatitis type of mushroom poisoning in children were dealed with drug treatment ,cured 12 cases,5 deaths,the cure rate of 70.6%;all patients,red blood cells,white blood cells and hemoglobin were normal ,7 cases of blood in the stool,6 cases of hematuria .All patients transaminase liver function tests and jaundice index were significantly in-creased,electrocardiogram showed sinus bradycardia 8 cases, sinus tachycardia 2 cases,1 case of renal damage. Conclusion Toxic hepatitis type mushroom poisoning mortality ,the elimination of toxins is where the key to have a certain effect of plasma exchange therapy ,liver transplantation is the most effective means of treatment ,especially gas-trointestinal bleeding with liver damage ,should be carried out as soon as possible based treatment plasmapheresis .

ObjectiveTo compare the effects of discharging sputum with machine vibration and percussion on back in patients with spinal cord injury (SCI) complicated with lung infection.Methods33 patients were divided into machine group (n=18, discharging sputum with machine vibration) and percussion group (n=15, discharging sputum with percussion on back). Then the auscultation of lungs, change of Sp2, abatement time of fever, white blood cells count and X-ray results of chest were compared to estimate the effect of discharging sputum.ResultsThere was a significant difference in the auscultation of lungs between the two groups ( P<0.05), while no significant difference was founded in the SpO2 between two groups after sputum discharged ( P>0.05). The abatement time of fever was shortened significantly in the machine group after treatment( P<0.05). The X-ray results improved significantly in the machine group, compared with percussion group ( P< 0.05).ConclusionThe effect of discharging sputum with machine vibration is better than percussion on back.

Objective To explore the effect of the Blood Circulation Punching Apparatus in the blood pressure of the spinal cord injury(SCI) patient with hypotension.Methods 28 patients with spinal cord injury were divided into two groups, the treatment group and the control group. The blood pressure was recorded before and after treatment, then changes of the blood pressure were compared.Results Both diastolic and systolic blood pressure increased in two groups（P<0.05）. Though no significant difference was found between two groups before treatment, significant difference was found between two groups after treatment（P<0.05）.Conclusion The Blood Circulation Punching Apparatus could improve the blood pressure of SCI patients with hypotension significantly.

由于近期地震,在ICU内多脏器功能衰竭的发生率与病死率极高,对高危患者进行严密监测,能早诊断、早治疗,积极护理,阻断由单一受累脏器向多脏器发展的病理生理过程,从而降低病死率。肺部改变、肾改变、脑改变、心血管改变、胃肠道改变、肝脏改变、弥散性血管内凝血是导致多脏器功能衰竭的常见原因。脏器衰竭越多,病死率越高,2个器官衰竭病死率为30%,3个达70%,4个为90%～100%。严密的观察监测及积极护理,是维持良好的呼吸、循环、胃肠功能、肾功能,能使器官受损的严重性和数目降到最低限度。

Thrombelastography (TEG) is an image presenting the viscoelasticity changes of blood clot in the process of blood clotting,consequently reflecting the ability of blood clotting and fibrinolysis.TEG is increasingly used in the field of guiding intraoperative blood transfusion,monitoring the Blood coagulation function,treating trauma patient,and monitoring the blood coagulation and fibrinolytic function of a variety of diseases,due to its rapid and accurate results.We discuss the clinical applications progress of TEG in this article.

The postoperative management of papillary thyroid microcarcinoma (PTMC) is one of the most important parts of management for PTMC,and it includes the initial management and long-term management of PTMC.The initial management of thyroid cancer is based on initial recurrence risk stratification system.The initial risk stratification system can be used to guide initial TSH suppression therapy,RAI assistant therapy and management of follow up.Initial risk assessment of recurrence,as a static representation of the patient in the first few weeks post-operatively,could not be continually updated during follow up.In order to account for the changes of the recurrence risk and disease specific mortality,re-stratification of risk should be performed during follow up,using all the clinical,biochemical,imaging (structural and functional),and cytopathologic findings obtained during follow up.Re-stratification of risk can inform clinicians on degree of ongoing TSH suppression,frequency and intensity of follow-up,and need for additional therapies were recommended in guideline.Adjustment of TSH suppression therapy should incorporate the impact of side effects and set TSH targets to ensure the benefits of TSH suppression outweigh against the potential risks.

Objective To analyze the sequence of the novel conjugative plasmid pO157_Sal detected in outbreak isolates of Escherichia coli O157∶H7 .Methods The traE genes of the outbreak isolates in China were amplified by polymerase chain reaction (PCR) and the products were sequenced .The TraE sequences of Escherichia coli O157 ∶ H7 strains from other sources were retrieved from GenBank . Phylogenetic tree based on the TraE sequences was constructed by Neibhor-joining analysis .The whole plasmid sequences of pO157_Sal and pEC4115 were compared .Results The sequences of traE gene were identical among the Chinese isolates . There were homologous sequences of TraE in Escherichia coli O157∶H7 isolates from different sources .Twenty-one out of the 52 pO157_Sal genes were homologous to genes of pEC4115 with amino acid level identity ranging from 28% to 51% .Conclusions Although similar TraE sequences and similar plasmid are found in Escherichia coli O157∶H7 isolates from different sources ,pO157_Sal is only observed in Chinese outbreak isolates .The TraE sequences are conservative among the outbreak isolates ,indicating they are from the same specific source .

Objective To develop a new intelligent medicine chest to update medical prescription and select medicine automatically based on the patient's requirements.Methods Information interaction was realized with Bluetooth and the connection between Java-based Yiyi health management app and a PLC module of the chest,so that auto dressing,medicine sorting and distribution could be executed according to medical prescription.The medicine chest was composed of PLC,constant-speed motor,sheave,lead rail mechanism,guide slot for medicine distribution,base,stricking mechanism and pushpull electromagnet.Results The chest eliminated medicine abuse,missed use or excessire use of the elderly.Conclusion The chest gains advantages in structure and function,and thus is worthy promoting practically.

OBJECTIVE:To establish a method for the simultaneous determination of psoralen,isopsoralen,epimedin B,epi-medin C and icariin in Chanlong dingchuan mixture. METHODS:HPLC was performed on the column of Welch Materials C18 with mobile phase of acetonitrile- methanol(1∶1,V/V)-water(gradient elution)at a flow rate of 0.9 ml/min,the detection wavelength was 246 nm(psoralen,isopsoralen)and 270 nm(epimedin B,epimedin C and icariin),column temperature was 30 ℃,injection volume was 20 μl. RESULTS:The linear range was 8.24-164.80 μg/ml for psoralen(r=0.999 7),5.15-103.00 μg/ml for isopso-ralen(r=0.999 3),4.06-81.20 μg/ml for epimedin B(r=0.999 6),5.88-117.60 μg/ml for epimedin C(r=0.999 5)and 4.90-98.00μg/ml for icariin(r=0.999 8);the limits of quantitation were 0.385 μg/ml,0.179 μg/ml ,0.124 μg/ml,0.218 μg/ml and 0.348 μg/ml, limits of detection were 0.127μg/ml,0.059μg/ml ,0.041μg/ml,0.072μg/ml and 0.115μg/ml;RSDs of precision,stability and re-producibility tests were lower than 2.0%;recoveries were 97.93%-100.06%(RSD=0.80%,n=6),96.91%-100.16%(RSD=1.37%,n=6),96.95%-99.63%(RSD=0.98%,n=6),96.69%-99.33%(RSD=1.03%,n=6) and 96.76%-98.53%(RSD=0.70%,n=6),respectively. CONCLUSIONS:The method is simple and reliable,and suitable for the simultaneous determination of psoralen,isopsoralen,epimedin B,epimedin C and icariin in Chanlong dingchuan mixture.

Objective To explore the clinical effect of cognitive function training joint hydrochloride donepezil in the treatment of cerebral stroke cognitive dysfunction.Methods 60 cerebral stroke patients with cognitive dysfunction were divided into two groups randomly,each group 30 cases.The patients of the two groups were given corresponding improving circulation and other conventional treatment measures,including giving hydrochloride donepezil treatment to A group and cognitive function training on the based treatment of group A to group B.Before treatment and after treatment 1 month,3 months,clinical dementia rating scale(CDR),simple mental state scale of mini-mental state examination (MMSE) and daily life events scale (ADL) ability evaluation were compared between the two groups.Results Of the two groups,CDR scores [(2.3 ± 0.5) points,(1.9 ± 0.6) points] and ADL [(43.3 ± 12.5) points,(39.6 ± 12.2) points] were lower than those before treatment [(2.6 ± 0.6) points,(2.6 ± 0.5) points,(49.6 ± 11.2) points,(48.3 ± 12.5) points] (all P ＜ 0.05),and MMSE scores [(20.6 ± 3.2) points,(21.0 ±3.5) points] were no different to those before treatment [(19.3 ± 3.5) points,(19.6 ± 3.2) points] ;3 months after treatment,CDR scores [(1.6 ± 0.5) points,(1.3 ± 0.5) points],MMSE scores [(23.3 ± 3.5) points (25.6 ±3.2)points] and ADL scores[(39.6 ± 11.2)points (33.3 ± 12.5)points]were significandy improved,and which of B group improved obviously.Conclusion Cognitive function training joint hydrochloride donepezil in the treatment of cerebral stroke cognitive dysfunction is more effective than hydrochloride donepezil alone,and can more obviously improve the symptoms of patients,and promote the quality of life,and it is worth for clinical application.