Objective To observe and investigate b-type natriuretic peptide(BNP)levels in patients with hemorrhagic fever of seriously renal syndromes line of continuous renal replacement therapy(CRRT)application value.Methods From January 2015 to October 2015 were 48 cases of patients with hemorrhagic fever of seriously renal syndromes as the research object.Conservative treatment after 3 d better person to be included in the control group(24cases), no better continue CRRT(CRRT group, 24cases).Records in the two groups before the conservative treatment in patients with mean arterial pressure(MAP), albumin(propagated), hemoglobin(Hb), b-type natriuretic peptide(BNP)and a 24 h urine(24 h urine);Record after conservative treatment 3 d urea nitrogen, serum creatinine, BNP and 24 h urine(24 h urine).Compare the differences between the two groups of the clinical indicators.Results The control group with CRRT group propagated, urea nitrogen, serum creatinine, BNP-I, BNP-Ⅱ, 24 h urine-Ⅰ, 24 h urine-Ⅱ comparison, the difference had statistical significance (P<0.05).Conclusion The short term the 24 h urine after conservative treatment and BNP levels can better predict whether patients with hemorrhagic fever of Seriously renal syndromes should be line of CRRT.

Objective:To compare behavior problems of children in town and countryside in east China Method:1983 children of 6 years old were collected from towns and countryside of Cangnan county of Zhejiang province They were assessed with Rutter's Children Behavioral Scale The rate of return was 94 3% Result:The prevalence of behavior problems in children of countryside was 12 8%, that of children of town was 7 7% In both children from town and countryside, negative rearing attitudes (i e scold and hit, indulgent), pressure of school exam were all risk factors for behavior problems In children from countryside, risk factors included mother's disadvantage factors In children from town, the risk factors included father's personal problems Conclusion:There were some difference in behavior problems and related factors of children of countryside and town

Medical team resource management is an effective way to control medical risk, ensure patient safety and enhance patient satisfaction. Based on defining the connotation, this paper illustrates the application and expe-rience of medical team resource management in Taiwan and finally proposes suggestions to apply medical team re-source management in domestic medical practice.

Objective To evaluate the effect of curcumin on spinal inflammatory factor in rats with diabetic neuropathy. Methods Diabetic neuropathy was induced by intraperitoneal injection with 1% STZ (60 mg/kg) in sprague-dawley rats. These diabetic rats were randomly allocated to diabetic group (D group, n=10) and curcumin group ( C group , n = 10 ) . Another 10 age-matched normal rats served as controlled group ( N group , n = 10 ) . 28 days after STZ injection, the rats in C group received daily intragastric administration of curcumin (200 mg/kg) whereas those in D group received the same volume of normal saline for 2 weeks. Caudal vein blood glucose levels at T1( before STZ injection)and at T2-T8(2、7、14、21、28、35、42 days after STZ injection)from all rats were detected. Responses to the mechanical stimulus were measured with von Frey filament, and paw withdraw threshold (PWT) was recorded at T1 and at T3 to T8. At T8,the rats were killed and lumbar segments of spinal cord were removed to detect TNF-αand IL-6 content. Results Compared to N group, rats in both C and D group showed hyperglycemia at T2 to T8 (P<0.05) and lower PWT at T4~ 8 (P < 0.01). Compared to D group, C group showed higher PWT at T7,8(P<0.05). Both D and C group showed higher levels of blood sugar at T2 ~ 8 than that at T1 (P < 0.05). C group showed higher PWT at T7,8 than that at T6(P<0.05). Compared to N group,spinal TNF-αand IL-6 content increased in both D and C groups (P<0.05). Compared to D group, C group had reduction of TNF-αand IL-6 concentration (P < 0.05). Conclusion Curcumin can attenuate diabetic neuropathic pain on rats probably by reducing inflammatory factor in spinal cord.

Objective To discuss the diagnosis and treatment of Cushing's disease without remission after transsphenoidal surgery.Methods 12 patients of Cushing's disease without remission after transsphenoidal surgery were investigated in this retrospective study.There were 2 males and 10 females with an average age of 36 (21-46) years old.Cushing's disease was diagnosed with the typical symptoms and signs of Cushing's syndrome,endocrinological examination and CT or MRI.Transsphenoidal surgery was performed in all patients.None of the patients achieved remission after operation.Serum and urinary free cortisol (UFC)were still elevated 3 months after operation.Subtotal adrenalectomy combined with pituitary radiotherapy were performed in 5 patients,single subtotal adrenalectomy in 4,pituitary radiotherapy in 2 and bilateral adrenalectomy with adrenal autotransplantation in 1 patient.Results Those receiving subtotal adrenalectomy combined with pituitary radiotherapy had no recurrence or Nelson's syndrome during 20 years of follow-up,but 4 patients receiving single subtotal adrenalectomy recurred after 2 to 9 years after operation.2 patients achieved remission with pituitary radiotherapy 1 to 2 years later without recurrence during 5 years of follow-up.One patient who underwent bilateral adrenalectomy with adrenal autotransplantation needed steroid replacement and Nelson's syndrome occurred during 2 years of follow-up because transplanted adrenal gland had no function.Conclusion The diagnosis of Cushing's disease should be reconfirmed for patients without remission after transsphenoidal surgery and the treatment should be individualized based on the results of operation,pathology and imaging.

Liver fibrosis occurs as compensatory responses to tis-sue repairing process in a wide range of chronic liver injures.It is characterized by excessive deposition of extracellular matrix (ECM)in liver tissues.The new discovery shows that suppres-sor of cytokine signaling (SOCS-3)is strictly associated with fi-brogenic progression of chronic liver diseases.Recent basic and clinical investigations also demonstrate that liver fibrogenesis is accompanied by SOCS-3,which critically determines the patho-
genesis and prognosis of liver fibrosis.This review summarizes current knowledge on SOCS-3 and the relationships between SOCS-3 and liver fibrosis.On the other hand,it also presents the different strategies that have been used in experimental mod-els to counteract excessive SOCS-3 and the role of SOCS-3 in the prevention and treatment of liver fibrosis.

Objective To explore the predictive effect of depression and impulsivity on suicidal ideation in violent criminals.methods 423 violent criminals were assessed by Self-rating Idea of Suicide Scale(SIOSS),Patient Health Questionnaire (PHQ-9) and Barratt Impulsiveness Scale(BIS-11).Result sPeople with suicidal ideation accounted for 17.04% of the total number of violent criminals.The scores of the group with suicidal ideation (respectively (4.95±4.82),(56.79±8.68),(12.95±2.29),(19.03±3.91),(28.81±4.95)) were higher than those without suicidal ideation group (respectively (4.95±4.82),(56.79±8.68),(12.95±2.29),(19.03±3.91),(28.81±4.95)) in depression and every dimension of impulsivity(attentional impulsivity,motor impulsivity and non-planning impulsivity) (t=9.49,t=4.61,t=4.04,t=3.88,t=3.08) (all P<0.01).Positive correlation was observed between suicidal ideation,depression and impulsivity(r=0.156-0.628,P<0.01),while sleeping factor was not associated with non-planning impulsivity.According to the multi-factoral regression module,depression and nonplanning impulsivity scores had positive prediction on suicidal ideation(R2=0.419,SIOSS=-2.471+ 0.192× depression+ 0.149× nonplanning impulsivity).Conclusion There is a close relationship in suicidal ideation,depression and impulsivity,meanwhile depression and nonplanning impulsivity can predict the suicidal ideation.

Farnesoid X receptor ( FXR) plays a key role in me-tabolism of substance, such as bile acid, lipid, glucose,( etc) . Newly published credible discoveries have claimed that as a reg-ulatory hub in metabolism, FXR is closely linked with diverse chronic liver diseases, including viral hepatitis, alcoholic fatty liver disease, nonalcoholic fatty liver disease, hepatic fibrosis and hepatocellular carcinoma. This review summarizes the roles and mechanisms of FXR during the courses of chronic liver dis-eases, aiming at providing novel insights and therapeutic target for antifibrotic research and drug development.

Objective To explore the diagnosis and treatment of adrenocorticotropin-independent macronodular adrenal hyperplasia (AIMAH). Methods The clinical symptoms, endocrinological and radiological characteristics, treatment modalities, and postoperative clinical course of 12 AIMAH patients were retrospectively reviewed. There were 5 men and 7 women with an average age of 48 years old. Results All cases had some clinical features and biochemical evidence of Cushing's syndrome. The circadian rhythm of serum cortisol was abnormal. Low- and high-dose dexamethasone suppression tests failed to suppress cortisol secretion. CT or MRI scan showed bilateral enlargement of the adrenal glands with multiple macronodules. Bilateral adrenalectomy was performed in three patients and unilateral adrenalectomy combined with contralateral subtotal adrenalectomy was performed in one patient. Seven patients underwent unilateral adrenalectomy of the larger gland. The removed adrenal glands weighted within 8-96 g range and pathologic diagnoses were nodular or adenomatoid hyperplasia of adrenal cortex. The duration of postoperative follow-up was 14 to 124 months. Clinical symptoms of Cushing's syndrome disappeared after surgery in all cases and there was no Nelson's syndrome after bilateral adrenalectomy. Urinary free cortisol and serum cortisol were within normal ranges. No further enlargement of the contralateral gland has been noticed in patients who received unilateral adrenalectomy during the follow-up.Conclusions AIMAH had unique endocrinological and pathological features. Unilateral adrenalectomy appears to be an effective and safe alternative treatment for AIMAH. Bilateral adrenalectomy or unilateral adrenalectomy combined with contralateral subtotal adrenalectomy may be performed if the symptoms had not been improved or recurred after unilateral adrenalectomy.

Objective To evaluate the effect of intrathecal rapamycin on diabetic neuropathic pain in rats.Methods Thirty adult male Sprague-Dawley rats,weighing 180-220 g,in which IT catheters were successfully implanted,were randomly divided into 5 groups (n =6 each) using a random number table:control group (group C),diabetic neuropathic pain group (group DN),rapamycin 1 μg group (group R1),rapamycin 3 μg group (group R3) and rapamycin 10 μg (group R10).Diabetes mellitus was induced by intraperitoneal streptozotocin (STZ) 60 mg/kg on 5 days after IT catheters were implanted in DN,R1,R3 and R10 groups.Citric acid-sodium citrate buffer 6 ml/kg was injected intraperitoneally in group C.In R1,R3 and R10 groups,rapamycin (dissolved in 10 μl 4％ dimethyl sulfoxide) 1,3 and 10 μg were intrathecally injected,respectively,once a day for 7 consecutive days starting from day 21 after STZ injection,while the equal volume of 4％ dimethyl sulfoxide was given instead in C and DN groups.Paw withdrawal threshold (PWT) to yon Frey filament stimulation was measured before IT catheters were implanted,before STZ injection,on 7,14 and 21 days after STZ injection,and on 1,3,5 and 7 days after rapamycin administration.After measurement of PWT,the rats were sacrificed and L2-5 segments of the spinal cord were removed for determination of the expression of mTOR and phosphorylated mTOR (p-mTOR),S6K and phosphorylated S6K (p-S6K) (by Western blot) and expression of mTOR mRNA and S6K mRNA (by RT-PCR).Results Compared with group C,MWT was significantly decreased at 14 and 21 days after STZ injection in DN,R1,R3 and R10 groups,and the expression of mTOR,p-mTOR,S6K,p-S6K,mTOR mRNA and S6K mRNA was up-regulated in group DN (P ＜ 0.01).Compared with group DN,MWT was significantly increased at 5 and 7 days after rapamycin administration in group R1,at 3,5 and 7 days after rapamycin administration in group R3,and at 1,3,5 and 7 days after rapamycin administration in group R10,and the expression of mTOR,p-mTOR,S6K,p-S6K,mTOR mRNA and S6K mRNA was down-regulated in R1,R3 and R10 groups (P ＜ 0.01).Conclusion Intrathecal rapamycin can alleviate diabetic neuropathic pain in rats.