Ageing of population is now a phenomenon of the world and has considerable consequences for public services.Ageing is always accompanied with dysfunction of multiple organs,including hypothalamic-pituitaryadrenal axis.Here,we summarized alterations of hormone secretion of adrenal glands in the elderly and their relationships with Alzheimer' s disease.Moreover,we discussed characteristics of pheochromocytoma,primary aldosteronism,and Cushing's syndrome in the elderly.Lack of typical manifestations usually makes difficulty in diagnosis.

This paper investigates 240 cases of medical disputes and interviews involved patients with questionnaires,explores patients′ behaviors,attitudes,and complaints in medical disputes,and analyzes the reasons and motivations for those behaviors and attitudes,in order to provide reference for reduce medical disputes and improve physician-patient relationship.

Objective:To observe the effect of acupoint injection with Neostigmine Methylsulfate at Zusanli (ST 36) on gastrointestinal function of patients after laparoscopic cholecystectomy. Methods:Totally 120 patients undergone laparoscopic cholecystectomy were randomized into an acupoint injection group, a muscular injection group, and a blank control group at 1:1:1 by random number table, 40 cases in each group. The blank control group was intervened by conventional post-operation treatment, the acupoint injection group was by acupoint injection with Neostigmine Methylsulfate 2 mL at bilateral Zusanli (ST 36) in addition to the treatment given to the blank control group, and the muscular injection group was by muscular injection with Neostigmine Methylsulfate 2 mL in addition to the treatment given to the blank control group. The two injection groups both received injection twice a day, totally for 3 d at most. The restored time of bowel sounds, initial flatulence time, defecation time and clinical efficacy were observed. Results:After treatment, there were significant differences in comparing the restored time of bowel sounds among the three groups (F=17.30,P<0.05), the acupoint injection group and muscular injection group were significantly different from the blank control group (P<0.05), and there was a significant difference between the acupoint injection group and muscular injection group (P<0.05); there were significant differences in comparing the initial flatulence time among the three groups (F=19.12,P<0.05), and the acupoint injection group was significantly different from the muscular injection group and the blank control group (P<0.05); there were significant differences in comparing the initial defecation time among the three groups (χ2=21.23,P<0.05), while the difference between the acupoint injection group and muscular injection group was statistically insignificant (P>0.05). The total effective rate was 87.5% in the acupoint injection group, versus 72.5% in the muscular injection group and 60.0% in the blank control group, and there were significant differences among the three groups (P<0.05). Conclusion:Acupoint injection with Neostigmine Methylsulfate at Zusanli (ST 36) can shorten the restored time of bowel sounds and flatulence time in patients undergone laparoscopic cholecystectomy, and the efficacy is more significant compared to muscular injection with Neostigmine Methylsulfate.

Objective:To explore the solutions to enhance the professional skills and humanistic quality of neurosurgery in theprimary hospitals, and to improve the neurosurgery medical care level.Methods: a comprehensive analysis of the literature retrieval as well as information collected in practice the first hospital of Zhangjiakou in, extract the problems of neurosurgeon training in primary hospital, to carry out grading treatment requirements, explore the basic path to improve the clinical ability of primary hospital neurosurgeon, and through the establishment of standard clinical operating procedures and systems to ensure the quality of medical service.Results: from Wanfang database retrieved from 2006 to 2015 research journals in Chinese on improving grassroots doctors ability of 819 papers, bibliometric analysis shows that the trend is increasing year by year, in 2015 issued a number is 5.21 times in 2006. There are 28 papers including neurosurgery area, accounting for 3.42% of the total number of papers; the hot topics focus in the mode of training neurosurgery doctors in primary hospitals,transfer the technology of minimally invasive neurosurgery and spreadmodern neurosurgery theory and knowledge.Conclusion: to improve the ability of doctorsof primary hospitals should be combined with the characteristics of local diseasesand primary hospital neurosurgeon status, from making training plan, appropriate to establish the corresponding clinical standard, promote the essential neurosurgery technology, in order to ensure implementation of the tiered diagnosis and treatment .

This paper presents a case of hyperthyroidism with myasthenia gravis (MG),diagnosed by neostigmine-test.Thyrotoxicosis and clinical manifestations of MG were controlled by acetylcholinesterase-inhibitor and immuno-suppressive medicine.Being followed for more than 2 years,the patient had been free of clinical symptoms of MG and his thyroid function was normal.

Idiopathic hypogonadotropic hypogonadism (IHH) is characterized by delayed or absent puberty and lowered sexual function as a result of impaired pulsatile gonadotropin-realeasing hormone (GnRH) secretion.Identification of TAC3/TACR3 mutations as the culprits of IHH revealed that neurokinin B (NKB) signaling pathway was involved in the regulation of pulsatile GnRH secretion.This review focuses on the involvement of NKB signaling in pulsatile GnRH release,the discovery of TAC3/TACR3 mutations and the phenotypes,and treatment of patients who carry TAC3 or/and TACR3 mutations.

0.05). The valve competence recovery rate in severe PDVI group was significantly lower than that of the mild and moderate PDVI groups (both P

Objective To explore the etiological factors of primary pathological duodenogastric reflux (DGR) through investigating the relationship between severity of bile refulx,the changes of surface gastric electric rhythm and gastric emptying movement in primary pathological DGR patients.Methods From January 2007 to April 2008 in Qingdao Municipal Hospital,58 cases of outpatients diagnosed as primary pathological DGR and 21 healthy individuals (control group) were collected and underwent 24-hour gastric bilirubin monitoring,gastric endoscopy,gastric electric rhythm,and gastric emptying test.The relationship between gastric electric parameters and gastric emptying,bilirubin reflux,Hp infection was analyzed.Results 1.The main frequency in fasting and postprandial of primary pathological DGR patients [(1.94±0.04) cpm vs (2.93±0.07) cpm; (2.12±0.03) cpm vs (3.35 ±0.05) cpm],the percentage of normal gastric slow wave in fasting and postprandial (74.46± 0.56 vs 85.55 ± 1.06 ; 63.97 ± 0.64 vs 86.13 ± 1.49),and fasting/postprandial power ratio (PR) (1.68±0.02 vs 2.75±0.09) were all lower than those of control group (P＜0.05).The percentage of bradygastria in fasting and postprandial of DGR patients (18.04±0.36 vs 7.76±0.78;23.73±0.91 vs 8.47±0.55),the percentage of tachygastria in fasting and postprandial (8.93±0.26 vs 5.75±0.66;13.02±0.40 vs 7.66±0.27) were higher than that of control group (P＜0.05).2.The main frequency of severe reflux patients in fasting and postprandial [( 1.68 ± 0.07) cpm vs (2.13 ± 0.07)cpm; (2.18±0.09) cpm vs (2.76±0.06) cpm],the percentage of normal gastric slow wave in fasting and postprandial (69.71±0.43 vs 80.35±0.68; 56.36 ±0.85 vs 72.34±0.80),fasting /postprandial PR (1.47±0.04 vs 2.02±0.04) were lower than those of mild-reflux group (P＜0.05).The percentage of bradygastria in fasting and postprandial of severe reflux patients (22.94 ± 0.68 vs 13.47 ± 0.61; 29.61 ± 1.14 vs 17.55 ± 0.51) and the percentage of tachygastria in fasting and postprandial (9.94 ± 0.54 vs 7.02 ± 0.42 ; 17.04 ± 0.70 vs 10.71 ± 0.20) were higher than that of mild-reflux group (P＜0.05).3.There was no significant difference of gastric electrical parameters in fasting and postprandial between Hp-positive and Hp-negative groups (P＞0.05).4.The ratio of gastric emptying in DGR group was significantly lower than that of control group (37.9％ vs 90.5 ％,P＜0.05).The gastric emptying delay in DGR group significantly increased compared with control group (60.3％ vs 9.5％,P＜0.05).There was no significant difference in gastric emptying delay between severe-reflux group and light-reflux group (69.0％ vs 51.7％,P ＞ 0.05).Conclusions There is dysfuntion of gastric myoelectrical activity and gastric motility in primary pathological DGR patients,which may be an important mechanism in pathological DGR.

OBJECTIVE To study and evaluate the value of the antibiotic-neutralized culture bottle applied by manual operations.METHODS A total of 711 blood samples were collected from clinical high fever patients in Qingdao Central Hospital from 2002 to 2005.To compare the bacteria detected rates,cultural time and bacteria types in 399 samples cultured in manual blood-culture bottles with those in 312 samples cultured in antibiotic-neutralized culture bottles applied by manual operations.RESULTS The bacteria detected rates were 10.28% in manual blood-culture bottles and 20.83% in antibiotic-neutralized culture bottles applied by manual operations.There was significant difference between both of them(P72h were no statistical difference between manual blood-culture bottles and antibiotic-neutralized culture bottles.Twenty species of bacteria were detected in manual blood-culture bottles and 29 species of bacteria in antibiotic-neutralized culture bottles applied by manual operations.CONCLUSIONS The bacteria detected rate and species of bacteria were more obviously raised in antibiotic-neutralized culture bottles applied by manual operations than in manual blood-culture bottles.

Objective To monitor the resistance of Streptococcus pneumoniae following the 2004 in Qingdao area, and to provide a reasonable basis for clinical application of antimicrobial agents. Methods Collecting respiratory tract, blood, cerebrospinal fluid and other specimens from out-patient and in-patients of some hospital in Qingdao from January 2005 to December 2008. According to the recommendation of NCCLS, antibiotic resistance analysis of 11 kinds of antibiotic to the isolated 231 Streptococcus pneumoniae by micro-agar dilution method, and analysis resistance trends and age differences. Results The results showed that the rate of Streptococcus pneumoniae not sensitive to penicillin is 23. 38% (PRSP: 9.52% , PISP: 13. 85% ) , resistant to cefotaxime is 9. 96% (23/231), resistant to amoxicillin is 12. 55% , resistant to erythromycin is 90. 48% (209/231). PRSP rate of patients younger than 14 years of age 27. 91% (12/43), significantly higher than that of the PRSP rate of adults 5. 38% (10/186). Conclusion The rate of resistant to penicillin Streptococcus pneumoniae increased significantly from 2004, and an increasing trend year by year, the resistance of Streptococcus pneumoniae is also a rising trend year by year. For patients infected low penicillin-resistant Streptococcus pneumoniae in this region, cefotaxime, amoxicillin are preferred drugs.