Objective:Examine and Compare the professional ethical attitudes and beliefs for counseling and psychotherapy between counselors/psychotherapists and clients who receive professional services in the field.Method:A questionnaire concerning ethical behaviors and attitudes was developed based on American Counseling Association Code of Ethics(2005),and administrated to 48 counselors/psychotherapists as well as 48 clients.The similarity and difference between ethical attitudes and beliefs of two groups were compared.Besides,the possible influences of certain important demographical variables were explored.Results:The two groups' responses differed in 12 out of 29 items,including 4 items derived from section of counseling relationship in ACA code of ethics(e.g.,47.9% clients thought clients could form personal relationship with counselors/psychotherapists,while only 4.2% professionals thought it was ethical,P

Objective To investigate the clinical features of rheumatoid arthritis (RA) associated with thyroid function abnormalities.Methods Serum thyroid function,anti-thyroglobulin antibodies (TGAb) and anti-thyroid peroxidase antibodies (TPOAb) were detected in 186 RA patients.Clinical data were then analyzed.Comparison of continuous data between groups was made by t test,while comparison of categorical data was made by x2 test.The non-normal distribution of the data was analyzed by Mann-Whitney U rank sum test.Results Fifty-six RA cases (30％) had abnormal thyroid function,including 25 low T3 syndrome cases,16 subclinical hypothyroidism cases,10 hypothyroidism cases and 5 Graves' disease cases.Among them 23 cases were diagnosed as Hashimoto's thyroiditis.The positive rate in the hypothyroidism group with chills (45 cases,80.3％,x2=99.94),lazy words (14 cases,25.0％;x2=7.896),lethargy (24 cases,42.9％;x2=7.433) and abdominal distension (21 cases,37.5％;x2=7.15) was higher than that in the group with normal thyroid function (all P＜0.05).Level of serum high density lipoprotein was decreased in hypothyroid group [(1.0±0.5) mmol/L vs (1.4±0.6) mmol/L,t=4.087,P＜0.05].Patients with abnormal thyroid function had higher positive rate of ANA [(10 cases,7.7％) vs (25 cases,44.5％),x2=34.98],anti-SSA [(3 cases,2.3％) vs (23 cases,41.1％),x2=48.91],anti-SSB [(2 cases,1.5％) vs (12 cases,21.4％),x2=22.25],TGAb [(20 cases,15.4％) vs (43 cases,76.7％),x2=65.88] and TPOAb [(13 cases,10.0％) vs (27 cases,48.2％),x2=35.90] than those with normal thyroid function (all P＜O.05).Conclusion Rheumatoid arthritis is often accompanied by thyroid disease.The positive rate of auto-antibodies in RA with abnormal thyroid function is higher than those with normal thyroid function and has no relationship with the disease activity.

Objective To discuss the correlation of P-glycoprotein(P-gp) and lymphocyte subgroup(CD4+,CD8+) in patients with immune thrombocytopenia.Methods A total of 20 patients with immune thrombocytopenia were selected from August 2015 to September 2016 in the Eighth Hospital Affiliated to Sun Yat-sen University.According to the platelet count,all patients were divided into mild group and severe group,20 cases of health persons were selected at the same period as the healthy group,flow cytometry technique was used to detect the plasma lymphocyte subsets(CD4+,CD8+) and P-gp level of all the objects.Pearson correlation analysis was used to analyze the relationship between plasma P-gp and plasma CD4+,CD8+,CD4+ / CD8+ level,analyzed all the objects plasma platelet count,P-gp and CD4+,CD8+,CD4+ / CD8+ levels.Results Plasma CD4+,CD8+,CD4+ / CD8+ and P-gp level of severe group were significant higher than those of mild group(t=3.587,2.957,2.315,2.646,P<0.05),plasma CD4+,CD8+,CD4+ / CD8+ and P-gp level of mild group patients were significant higher than those of healthy group(t=5.479,2.921,4.536,7.750,P<0.05).Pearson correlation analysis results showed that the plasma levels of P-gp and plasma CD4+,CD8+,CD4+ / CD8+ levels were positively correlated(r=0.683,0.617,0.548,P<0.05).Conclusion Plasma CD4+,CD8+,CD4+/CD8+and P-gp level is associated with immune thrombocytopenia patients condition,plasma levels of P-gp closely links with abnormal immune function in patients with hyperthyroidism,prompting detection the level of change could help doctors to assess patients medication curative effect.

Objective To study the clinical characteristics of inherited metabolic disease(IMD) in the neonatal intensive care unit and to improve the ability of early diagnosis of the disease.Methods A total of 5 590 newborns were hospitalized in the Neonatal Intensive Care Unit (NICU),Fujian Maternity and Children Hospital between January 2012 and April 2015,and 340 neonates who were suspected of IMD consecutively were recruited.Tandem mass spectrometry and gas chromatography-tandem mass spectrometry were used to diagnose IMD.A retrospective study of analyzing the clinical characteristics of the patients of IMD in the NICU was conducted.Results Fifteen neonates were diagnosed as IMD,among whom methylmalonic academia,maple syrup urine disease,hyperphenylalaninemia,citrin deficiency,propionic acidemia,glutaric academia,ornithine transcarbamylase deficiency and primary carnitine deficiency were 5,2,2,2,1,1,1 and 1,respectively.Sixty-six point seven percent (10/15 cases) of IMD onset in the first week after birth were severe.Clinical presentations include the nervous was severe,digestive system and respiratory system symptoms,such as poor response,coma,lethargy,dystonia,convulsion,shortness of breath,dyspnea,milk refusal,diarrhea,jaundice,and so on.The main early manifestations were anorexia,lethargy,seizures and shortness of breath,which were nonspecific.Conclusions Clinical manifestations of IMD are nonspecific.The earlier onset of the disease is more serious,and early tandem mass spectrometry and gas phase chromatography-mass spectrometry are useful for early diagnosis and may guide early clinical intervention.

ObjectiveTo reveal status in quo of rehabilitation research according to rehabilitation periodical literature.MethodsMEDLINE and CBM are the retrieval databases during 1995—2002. ICD-10 is the main classification tool of central nervous diseases.ResultsThe percentage of rehabilitation literature is 1.32% on MEDLINE, 1.53% on CBM during 1995—2002. The ratio of rehabilitation literature is 1.67 between MEDLINE and CBM. The common study fields include stroke, paraplegia, hypertension, cerebral palsy, hemiplegia, Parkinson disease, epilepsy, and cerebral infarction, etc.The foreign study takes advantage in multiple sclerosis, and tetraplegia, etc. The fewer fields are neuromyelitis optica, arachnoiditis, and Huntington's disease, etc.ConclusionsThe study of central nervous disease rehabilitation is generally similar on some common CNS diseases, some foreign studies taking advantage.

Objective To investigate the prevalence of tuberculosis among silicosis patients and silica exposure patients,and to analysis the risk factors of tuberculosis among these population.Methods A total of 1 227 silica exposure patients from Wenling,Zhejiang were enrolled in this field study.Basic demographic information was collected and chest X-ray was taken for each patient.Sputum was collected for Mycobacterium tuberculosis culture and strain identification. In univariate analysis,t test was performed for continuous variables andχ2 test for categorical variables.In multivariate analysis,the odds ratio (OR )was calculated along with a 95 % confidence interval (CI )by binary Logistic regression. Results A total of 1 204 silica exposure patients had full basic information and 99.8% were male patients with mean age of (59.4 ± 6.8 )years.The patients in phase 0 + to phase Ⅲ were 172 (14.3%),255 (21 .2%),160 (13.3%)and 617 (51 .2%),respectively.The tuberculosis prevalence rate was about 7.3% among these population.The risk factors for tuberculosis including phase Ⅱ silicosis (OR =2.96, 95 %CI :1 .05 -8.32,P =0.04)and phase Ⅲ silicosis (OR=3.88,95 %CI :1 .58-9.56,P <0.01),and contacting with tuberculosis patients (OR=4.14,95 %CI :1 .91 -8.98,P <0.01).Patients complicated with tuberculosis lacked specific symptoms,but fever and weight loss were more frequent.Conclusion Tuberculosis is highly prevalent in silicotic patients,especially in patients with phase Ⅱ/Ⅲ silicosis and in patients with tuberculosis contact history.

This work is directed at developing a virtual instrument system as an accessorial diagnostic instrument for laryngeal diseases. Programmed with LabWindows/CVI, the system combines the voice acoustic analyzing function with the glottal image measuring function. The voice acoustic analyzing system can sample, store and replay vocal signals; can extract and analyze parameters, including fundamental frequency (F0), frequency perturbation quotient (FPQ), amplitude perturbation quotient(APQ), harmonics-to-noise ratio (HNR), jitter frequency (JF), Shimmer; and can do 3D sound graph analysis. The glottal image analyzing system can sample and store the image observed by the laryngostroboscope; can display any phase in one cycle of the vibration of the vocal cords or a slow and continuous movement of vibrating vocal cords; can snap and save the diagnostic frame of image; and can extract the parameters of the image such as the length and area of the glottis, the length and area of the vocal cords and the diseased part.
Computer Simulation ; Diagnosis, Computer-Assisted ; instrumentation ; methods ; Glottis ; physiology ; Humans ; Image Processing, Computer-Assisted ; Laryngeal Diseases ; diagnosis ; User-Computer Interface ; Voice ; physiology

Objective To evaluate the effects of the quality-improving program on reducing the bloodstream infection of preterm infants in NICU.The program included emphasizing hand hygiene,strictly controlling the use of antibiotics and following the extubation indications of peripherally inserted central catheter (PICC).Method From October 2016 to March 2017,preterm infants admitted to NICU after the implementation of quality improvement program were assigned into the intervention group,and the infants admitted from April 2016 to September 2016 without the program were in the control group.The x2 test and t test were used to analyse the effects of the program,the rate of bloodstream infection and related complications.Result A total of 432 cases were enrolled in this study.Among them,221 cases were in the intervention group and 211 cases the control group.The rate of hand hygiene in the intervention group was significantly higher and the duration of antibiotic use per 1 000 hospitalization days and the average days of retaining the PICC were significantly shorter than the control group (P ＜ 0.001).The incidence of bloodstream infection in the intervention group was lower than the control group (5.9％ vs.11.4％,P =0.047),and the duration of non-invasive ventilation,parenteral nutrition,average hospitalization days,and the incidence of stage 11 and above necrotizing enterocolitis were lower than the control group (P ＜ 0.05).Conclusion The evidence-based quality improvement program has positive effects on reducing the bloodstream infections and related complications of preterm infants in NICU.

Objective To explore the efficacy and safety of high-dose second-generation fat emulsion usage on the very low birth weight premature infants.Methods A total of 88 premature infants with very low birth weight (VLBW) in Neonatal Intensive Care Unit (NICU)of Fujian Provincial Maternity and Children Hospital,Affiliated Hospital of Fujian Medical University from December 2013 to December 2014 were randomly divided into experimental group and control group,with 44 cases in each group according to the table of random number.The experimental group received intravenous nutrition with 200 g/L second-generation fat emulsion within 24 hours after birth,the initial dose was 2.0 g/(kg · d) with an increase of (0.5-1.0) g/(kg · d) daily,the maximum dose was 3.5 g/(kg · d);the control group received intravenous nutrition with 200 g/L second-generation fat emulsion 24 hours later after birth,the initial dose was 0.5 g/(kg · d) with an increase of 0.5 g/(kg · d) daily,the maximum dose was 3.5 g/(kg · d).The other intravenous nutrition methods were same.The general conditions at birth,blood biochemical parameters,growth parameters and complications were compared between the 2 groups.Results The mean value of intravenous nutrition duration,length of stay,the glucose infusion rates of postnatal days 6 and 7,the serum triglyceride levels of postnatal days 7,chest circumference of the fourth weeks,the incidence of the low triiodothyronine(T3) syndrome and parenteral nutrition associated cholestasis(PNAC) were (22.27 ± 7.17) d,(37.75 ± 12.28) d,(8.10 ± 0.92) mg/(kg · min),(8.49 ± 1.06) mg/(kg · min),0.18(0.03-0.59) mmol/L and (27.21 ± 1.62) cm in the experimental group respectively,but (27.36 ± 11.37) d,(44.36 ± 16.45) d,(7.98 ±0.79) mg/(kg · min),(8.22 ±0.76) mg/(kg · min),0.28 (0.07-0.99) mmol/L and (26.56 ± 0.96) cm in the control group,respectively,and the differences were statistically significant between the 2 groups (t =2.512,5.403,4.314,9.705,696.500,6.668,all P ＜ 0.05).The incidence of the T3 syndrome and parenteral nutrition associated cholestasis (PNAC) in the experimental group was 25.0％ (11/44 cases) and 0(0/44 cases),respectively,which were significantly lower than those in the control group[81.8％ (36/44 cases)and 9.1％ (4/44 cases)],and the differences were statistically significant between the 2 groups (x2 =28.542,5.736,all P ＜ 0.05).The 2 groups had no significant difference in the incidence rates of other complications such as necrotizing enterocolitis,infection,retinopathy of prematurity,bronchopulmonary dysplasia,and the duration of oxygen therapy and mechanical ventilation(all P ＞ 0.05).Conclusions The high-dose second-generation fat emulsion usage [the initial dose 2.0 g/(kg · d)] in VLBW infants is safe and well tolerated.Advisable parenteral nutrition support strategy can promote growth of VLBW infants,shorten the intravenous nutrition duration and length of stay,reduce the incidence of the low T3 syndrome and PNAC,which has no influence on the incidence rates of other complications.

Cryptococcal meningitis is a common and refractory central nervous system infection,with high rates of mortality and disability.The experts of the Society of Infectious Diseases of Chinese Medical Association have reached this consensus after a thorough discussion.Based on the current situation of cryptococcal meningitis in China,the management of cryptococcal meningitis includes 6 aspects:introduction,microorganism identification,clinical manifestations and diagnosis,principles of antifungal therapy,treatment of refractory and recurrent meningitis,treatment of intracranial hypertension.There is not a separate consensus on human immunodeficiency virus (HIV) infection in patients with cryptococcal meningitis.This article focuses on different antifungal regimens and reducing intracranial pressure by reference to Infectious Disease Society of America (IDSA) guidelines.The importance of early diagnosis,combined long-term antifungal therapy,control of intracranial hypertension are emphasized.