Guillain-Barré syndrome(GBS) has clinical characteristics:flaccid,symmetrical,ascending paralysis.Cranial nerves and respiratory muscle related,albuminocytologic dissociation in cerebrospinal fluid,and electrophysiological changes.GBS was believed to be an autoimmune perineuropathy.Recently,there were more and more reports about GBS spectrum disorders or GBS variant correlated with anti-GQ1b antibody or anti-GM1 IgG antibody et al.The GBS Classification Group presented the new clinical criteria in 2014,to enable neurologists and non-neurologists to diagnose GBS and all its variants using a simple yet all-inclusive classification system.

Objective To investigate how internet using (both time and activities)and effortful control would contribute to the sex difference of problematic internet use (PIU).Methods A total of 844 adolescents aged 9-20 years old were selected from Chinese Academy of Sciences twin-sample by simple random sampling,with boys accounting for 45.6％ and girls accounting for 54.4％.The internet using and effortful control were measured using self-report questionnaires in the first time(T1),the problematic internet use were measured after one and half years (T2).The difference and relation of Internet using,effortful control and problematic internet use between boys and girls were measured with Chi-square test,t test and correlation analysis.The moderating effect of sex between internet using and PIU were explored by utilizing regression analysis.The mediation effect of effortful control between sex and PIU were explored with Sobel test.Results The anverage internet time of working day and weekend in boys were 1.52 h and 2.12 h respectively.The average internet time of working day and weekend in girls were 1.49 b and 2.05 h respectively.Significant difference between boys and girls is not existed in the internet time (t=0.541,0.907,P＞0.05).And the boy was inclined to game(x2 =47.669,P＜0.01).The effortful control of boys and girls were 54.09 and 55.76 respectively.The score of boys' and girls' PIU were 22.48 and 20.72 respectively.Boys' effortful control was significantly lower than that of girls (t=-2.879,P＜0.01).The score of boys' PIU was significantly higher than that of girls' (t=3.612,P＜0.01).Adolescents' PIU were significantly correlated with the time,entertainment and social activities (r=0.249,0.175,0.140,P＜0.01).The moderating effect of sex was significant in the relation between internet time and PIU.Significant mediation effect of effortful control existed in the PIU difference between boys and girls(Z=-2.54,P＜0.05).Conclusion Significant mediation effect of effortful control exists in gender and PIU.

Objective To analyze the correlation between the resistance of Acinetobacter baumannii and the utilization of antimicrobial agents in the hospitalized patients of Beijng Chuiyangliu Hospital,and provide the basis for clinical rational use antimicrobial agents.Methods A retrospective analysis was conducted for the drug resistance rate and specimen source of the 2 194 strains of Acinetobacter baumannii from 2010 to 2014 in the hospital and DDDs/DUI of antimicrobial agents was analyzed by Pearson correlation.Results The resistance rate of Acinetobacter baumannii was positively correlated with the DDDs and DUI of imipenem/cilastatin(r=0.991,0.994,all P<0.01), and was positively correlated with the DDDs of cefepime(r=0.934,P=0.020).The resistance rate of Acinetobacter baumannii to amikacin was positively correlated with the DDDs of etimicin(r=0.931,P=0.022).The resistance rate of Acinetobacter baumannii was negatively correlated with the DUI of levofloxacin(r =-0.986,P =0.002). Conclusion The resistance rate of Acinetobacter baumannii was high and there was correlation between the drug resistance and the utilization of some antimicrobial agents.

Objective To explore the effects ofBuzhong Yiqi Pills on HBV-related decompensated liver cirrhosis patients.Methods A total of 176 patients of HBV-related decompensated liver cirrhosis were enrolled in the study from January 2007 to January 2010 and were divided into treatment group (82 cases) and control group (94 cases) according to patient's wishes. Patients in both groups were given antiviral therapy. According to the liver function and complications, patients were given glycyrrhizin to protect liver, Kuhuang Injection to treat jaundice, and spironolactone and furosemide for diuretic treatment. Patients in the treatment group receivedBuzhong Yiqi Pills, one bag for each time, twice a day, four weeks as a treatment session, three sessions each year, with five-year follow-up. Effects ofBuzhong Yiqi Pills on the hepatorenal function, blood coagulation, blood routine, complications and survival rate in patients with decompensated liver cirrhosis were observed.ResultsBuzhong Yiqi Pills could effectively improve the hepatorenal function, blood routine and coagulation disorders of HBV-related decompensated liver cirrhosis patients (P<0.05,P<0.01). The rate of complications with hydrothorax and ascites (46.34% vs. 88.30%), upper gastrointestinal hemorrhage (39.02% vs. 69.15%), infection (31.71% vs. 57.45%), hepatic encephalopathy (23.17% vs. 54.26%), hepatorenal syndrome (6.10% vs. 18.09%) and chronic hepatic failure (9.76% vs. 25.53%) in the treatment group and the control group were with statistical significance (P<0.05,P<0.01). The five-year survival rates were significantly higher in the treatment group (79.27%) compared with the control group (64.89%), with statistical significance (χ2=5.353,P=0.021).ConclusionLong term use ofBuzhong Yiqi Pills can significantly decrease the complications of HBV-related decompensated cirrhosis and improve survival rate of patients.

Objective To explore the correlations of lung resistance protein (LRP) and glutathione S transferase π (GST-π) to chemotherapy resistance and prognosis of epithelial ovarian cancer.Methods The expressions of LRP and GST-π in epithelial ovarian cancer were examined with immunohistochemistry.Correlations of LRP and GST-π to chemotherapy efficacy and survival time after operation were analyzed.Results The short-term efficacy rates of ovarian cancer were lower in patients with positive expressions of LRP and GST-π than those with negative expressions [61.2％,61.7％ vs 94.1％,89.5％,x2 =6.47,4.94,P =0.011,P =0.026].The positive rates of LRP and GST-π were significant higher in patients with chemotherapy resistance than in those sensitive to chemotherapy [91.3％,87.0％ vs 65.1％,62.8％,P ＜ 0.05].Log-rank test showed that patients with positive LRP and GST-π had shorter survival time than those negative,and patients with both positive LRP and GST-π had shorter survival time than those both negative (P ＜ 0.05).Conclusions The expressions of LRP and GST-π in epithelial ovarian cancer could be used to predict chemotherapy resistance and prognosis of patients.

The establishment of medical morality and behavior appraisal system and research on its application developed in comprehensive hospitals were clarified.Several aspects related to the medical morality and behavior appraisal,such as index,standard,approach,method,record and the result,were investigated and practiced,and the establishment of a scientific and reasonable medical morality and behavior appraisal system was investigated in the aspects of consummating the organization management of medical morality appraisal,subdividing the medical morality appraisal system,quantifying the medical morality appraisal standard,operating and performing the medical morality appraisal and establishing the electronic archives of medical morality appraisal to construct an efficient incentive and restraint mechanism,and moreover,to promote the establishment of hospital convention and the enhancement of the overall management level.

OBJECTIVE:To establish the pharmacokinetic-pharmacodynamic(PK-PD) model of Nisoldipine controlled-release patches(NCRP)in spontaneously hypertensive rats(SHR). METHODS:SHR were randomized into a patch(NCRP)group and a tablet(Nisoldipine tablets)group,with 6 rats in each group. The microdialysis probes were implanted in SHR. Each rat was given 5 mg nisoldipine. Plasma microdialysate was collected within 36 h after administration. HPLC was adopted to determine the plasma concentration of nisoldipine,and WinNonlin 5.3 was employed to calculate Pharmacokinetic parameters. With heart rate and blood pressure as pharmacodynamic indexes,PK-PD model study was conducted. RESULTS:Vs. nisoldipine tablets,NCRP has con-trolled release effect. The relationship between NCRP drug effect and effect-site concentration met the Sigmoid-Emax model. The main parameters of the PK-PD model for heart rate and systolic blood pressure were as follows as Emax of (2.65 ± 0.06) and (10.71 ± 0.87),EC50 of (83.65 ± 35.25) and (1.29 ± 0.26) ng/ml,γ of (0.83 ± 0.91) and (1.2 ± 0.35),Keo of (0.37 ± 0.53) and (0.91±0.24)h-1. CONCLUSIONS:PK-PD model of NCRP in SHR has been established successfully.

Objective To establish an animal model of high-iodine and low-protein in Wistar rats,and to observe the effect of combined excess-iodine and low-protein diet on growth,metabolism and morphological changes in thyroid.Methods According to body weight[(110 ± 10)g] and sex(half male and half female),one hundred and ninety-two Wistar rats,1 month after weaning,were randomly divided into ① normal iodine control group (NI),② 10-fold excess-iodine group (10HI),③ 50-fold excess-iodine group (50HI),④ 100-fold excess-iodine group (100HI),⑤ low-protein control group (LC),⑥ low-protein and l 0-fold excess-iodine group (L10HI),⑦low-protein and 50-fold excess-iodine group (L50HI),⑧ low-protein and 100-fold excess-iodine group(L100HI).Twenty-four rats were in each group,with the experimental period of 6 months.The iodine content of NI and LC groups was 4.65 μg/d; 10HI,50HI and 100HI groups were 46.50,232.50 and 465.00 μg/d,respectively.The animal's body weight,water and feed consumption were recorded weekly.At the end of 60,120,180 days,urine and blood samples were collected from eight rats in each group.Urinary iodine was tested by arseni cerium catalytic spectrophotometry; serum iodine was tested by the method of chloric acid.Histological change of the thyroid gland was observed by transmission electron microscopy and hematoxylin-eosin (HE) staining at the end of 6 months; apoptosis of thyroid was tested by terminal-deoxynucleoitidyl transferase mediated nick end labeling (TUNEL) method.Results At the end of 4,8,16,18,22 and 24 weeks,the differences of body mass of rats among groups were statistically significant(F =4.26,3.75,4.98,4.09,3.28,3.95,all P ＜ 0.05).At the end of 60,120,180 days,the differences of iodine concentration in urine and blood among groups were statistically significantly (H =5.37,6.03,all P ＜ 0.05).Light microscopy showed that thyroid follicular epithelial cells became flattened,and follicles became distended with colloid following increasing of iodine concentration.Electron microscopy showed increased glial vesicles,condensation of nuclear chromatin,karyopyknosis,and karyolysis with increasing of iodine concentration.The differences of apoptotic indexes among groups were statistically significant (F =4.59,P ＜ 0.01).The apoptotic indexes of L50HI and L100HI groups [(21.50 ± 5.20)‰,(26.70 ± 6.40)‰] were higher than those of 50HI and 100HI groups [(11.20 ± 4.30)‰,(19.40 ± 4.80)‰,P ＜ 0.01 or ＜ 0.05].Conclusion Excessiodine and low-protein can cause growth retardation,abnormal iodine metabolism,and thyroid follicular epithelium damage in Wistar rats.

Objective To study the determinants of exercise behavior among the overweight and obese residents, so as to provide reference for policy-making and health promotion in the future. Methods The study only enrolled overweight and obese residents to conduct a questionnaire survey and physical examination including height, weight and waist circumference. The self-designed questionnaire based on Health Belief Model had acceptable validity and reliability. Structural Equation Modeling was used to analyze the determinants of exercise behavior after univariate analysis and correlation analysis. Result Totally 2 489 overweight and obese residents(1 182 male and 1 307 female)were included in this study. Their average age was 45.3±14.2 years and their median amount of exercise was 4 thousand-step equivalent with quartile of (0.5, 10.0); 22.9% of these residents never took any exercise. Males with high school and equivalent level of education and an income of 5 000 to 10 000 yuan, took more exercise than other demographic groups. Amount of exercise had a positive correlation with perceived benefits of exercise, perceived severity of disadvantage of low exercise and self-efficacy, while it had a negative correlation with subjective barriers and objective barriers. Structural Equation Modeling showed that perceived subjective barriers, objective barriers and self-efficacy were determinants of exercise behavior. Their total standardized effects on exercise behavior were-0.085 (P=0.020),-0.242 (P<0.001) and 0.184 (P<0.001) respectively.Those with higher self-efficacy and less barriers preferred to do more exercise. Indirect effect widely existed in the SEM and self-efficacy were the most important mediating variables of all the other significant determinants. Conclusion The overweight and obese residents are seriously lack of exercise, which need some targeted intervention, especially by improving their self-efficacy and reducing their objective barriers.

Objective To analyze the epidemiological characteristics of brucellosis for improving its clinical and laboratory diag‐nostic ability .Methods The clinical and laboratorial data of the patients with brucellosis in our hospital from January 2013 to Sep‐tember 2015 were retrospectively analyzed .Results In 39 cases of brucellosis ,the majority had the sheep‐contacting history and the clinical manifestations were mainly fever (100 .0% ) ,bone and joint pain(64 .1% ) ,hidrosis(51 .3% ) ,weak(33 .3% ) ,lymph node en‐largement(23 .1% ) and hepatosplenomegaly(12 .8% ) .The laboratory detections showed the abnormal liver function ,rapid erythro‐cyte sedimentation rate(ESR) ,hypersensitive C ‐ reactive protein(hs‐CRP)increase ,lymphocytes percentage increase ,positive for brucellosis antibody agglutination test ,positive blood culture or medulloculture ,which was identified as Brucella melitensis by bacte‐riology .Conclusion The clinical manifestations of brucellosis are diversity and is easy to be misdiagnosed .The sporadic cases in northern Jiangsu area are increased year by year .The epidemiological clue should be paid attention to and the recognition on brucel‐losis should be strengthened .The patients with fever of undetermined origin should be conducted the blood culture and brucellosis antibody agglutination test as early as possible .