The clinical manifestations and endoscopic changes of inflammatory bowel disease (IBD) are complex and vary greatly according to the severity of the problem.The activity of the inflammatory bowel disease,macroscopic and microscopic features are closely related to disease progression and treatment response.The activity and the severity of IBD can be defined by pediatric ulcerative colitis activity index (PUCAI) and pediatric Crohn's disease activity index(PCDAI).According to the Montreal standards and Paris consensus,the extent of the endoscopic intestinal involvement and the severity of the lesion can be determined.It reflects the local changes before and after the treatment and reactions as time goes on.It's helpful to evaluate the severity and the treatment efficacy of IBD,to carry out multi-center and large-scale research through the activity score,macroscopic and microscopic features evaluation.

Objective To summarize the experiences of medical rescue in Wenchuan Earthquake and enhance the comprehensive competence of medical rescue in coping with heavy disaster.Methods By retrospectively and descriptively analyzing the data related to the casualties and the action of medical rescue in Wenchuan Earthquake from the macro level,combining with the author's experiences in the rescue work,the deep ponderation on the strategy of medical rescue in coping with heavy disaster was formed.Results The time distribution of the casualty could be divided into rising period and steady period by the time two weeks after Wenchuan Earthquake,and the casualties were mainly from 7 seriously destroyed areas(including Beichuan,Mianzhu,Shifang,Dujiangyan,Qingchuan,Wenchuan,Pengzhou),accounting for about 72.62% of all casualties.The medical teams rescued over 2 000 000 victims totally,among them 10 048 victims were evacuated from the distressed areas and well treated in 367 hospitals distributed in 20 provinces.Anti-epidemic measures were then carried out in the serious earthquake areas regionally and subject-specially,ensuring that the urgent medical aid was paid to all the injured people and no epidemics outbreak over the disaster areas after the earthquake.Conclusions Great efforts should be made to enhance the ability of medical rescue,such as the establishment of quick responding medical system;development of national medical rescue teams;accelerative construction of different medical rescue function modules;optimization of the national emergent medical rescue command system;reinforcement of the scientific research on disaster medicine and improvement of the national information network of medical rescue in emergency.

Perioperative hyperglycemia become more common nowadays, it will bring adverse effect to the prognosis of patients if it was poorly controlled. Proper perioperative blood glucose monitoring is very important to hyperglycemic management. This article will be reviewed from the different types, harm and monitoring status of perioperative hyperglycemia.

Objective To observe the effect of Banxie Xiexin decoction in the treatment of duodenum ulcer complicating HP infection and its influence on IL-6.Methods Retrospective analysis of 80 patients with duodenum ulcer complicating HP infection were conducted.The patients were tested by rapid urease test for Hp infection.All the patients were randomly divided into observation group (40 cases) and control group(40 cases) according to random number table generated by SPSS19.0.The control group was treated with triple therapy(omeprazole,clarithromycin,amoxicillin).The observation group was given Banxie Xiexin decoction on the basis of the control group,14d as a course.Before and after treatment,the Hp eradication rate was calculated.The epigastric burning,belching tunsuan,dry mouth and limbs without temperature score were measured.5mL fasting blood was exsanguinated to test IL-6.The clinical efficacy was compared.Results The eradication rate of Hp in the observation group was 85%,which was significantly higher than that in the control group(55%).The difference was statistically significant(χ2=8.571,P<0.05).The total effective rate of the observation group was 95%,which was significantly higher than that of the control group(75%).The difference was statistically significant(Z=-3.143,P<0.05).The epigastric burning,belching tunsuan,dry mouth and limbs without temperature score of the observation group and the control group after treatment were lower than before treatment(t=7.167 and 5.664,6.919 and 5.713,7.462 and 5.051,7.372 and 5.136,all P<0.05),which of the observation group after treatment were lower than those of the control group(t=4.501,4.464,4.388,4.506,all P<0.01).The IL-6 levels of the observation group and the control group after treatment were (184.3±92.2)pg/mL and (283.6±102.8)pg/mL respectively,which were significantly lower than before treatment(t=14.332,6.325,all P<0.05).The IL-6 level of the observation group after treatment was significantly lower than the control group(t=7.254,P<0.05).Conclusion Banxia Xiexin decoction can improve the clinical curative effect of triple therapy in the treatment of duodenum ulcer complicating HP infection,improve the clinical symptoms,improve the eradication rate of Hp and restrain the local inflammatory factors,so as to relieve mucosal injury.

Objective To summarize the experiences of the diagnostic and therapeutiec approach of hepatic trauma.Methods Referencing to the literature of recent years,we retrospectively analyzed the clinieal data of 55 cases of liver trauma.Results Among the 55 cases.18 eases of stage Ⅰ～Ⅱ.1 5 cases of stage Ⅲ,17 eases of stage Ⅳ and 5 cases of stage V,Thirty-one cases received non-operative treatment.and 24 cases reeeived operative therapy.In non-operative treatment group,the cure rate was 100%.In operation Ireatmenl group the cure rate was 91.7%.Conclusions Focused abdominal sonography for trauma (FAST) and diagnostic peritoneal paraeentesis are the initial methods for diagnosis of liver trauma and are largely used nowadays.When the patient is hemodynamically stable,CT scan or simuhaneous contrast-enhanced scan are important to decide for conservative ur surgical treatment.Today.treatment of hepatic lesions takes in account mainly two aspects:hemodynamically stability and the mechanism for trauma(blunt or penetrating).Liver injmy score of patienlS is not as important as the hemodynamie status for determining conservative management.Nonoperative management under close continuous observation for the hemodynamically stable patients with stage Ⅰ and Ⅱ and some eases of stage Ⅲ blunt hepatic injury has become the stamlard of care.The decision for surgical intervention should be given in time according to the variance of hemodynamically stability and the presence of trauma (blunt or penetrating).Some cases of stage Ⅲ and all cases of stage Ⅳ to Ⅴ hepatic injury shouht preferably undergo surgieal treatment.The effective preventive measures to decrease mortality in patients with severe hepatic trauma include early remedy to henmrhagie shock.effective hemostasis,complete abdominal drainage and prevention of pnstoperative enmplieations.

Objective To investigate the correlation between mental status of patients with stroke and their quality of life. Method One hundred and three stroke patients were measured by HRSD,HMAM and SS-QOL to explore the correlation between mental status and quality of life.Results Among the 103 patients,68 developed depression, taking up 66.02%,with a total score of 31.62±12.58;52 anxiety,taking up 50.49%,with a total score of 22.17±5.38.The level of depression and anxiety were negatively correlated with the life quality(P<0.01).Conclusions The occurence rate of depression and anxiety in stroke patients is higher. The higher the scores on depression and anxiety,the worse the quality of life.

Objective To compare the effects of aspirin and warfarin in the elderly patients with chronic nonvalve atrial fibrillation.Methods 431 elderly patients with chronic non-valvalar atrial fibrillation were randomly divided into two groups: group A received aspirin; group B received warfarin.After patients were treated with aspirin or warfarin for two years,the incidence rate of stroke and hemorrhage rate were counted. Results Aspirin was as effective as warfarin in preventing stroke in patients age 65 to 75 years old without risk factor,and warfarin was more effective than aspirin in preventing stroke in patients (≥75) and all patients with risk factors. Warfarin and aspirin had low incidence rate of bleeding. Conclusion For the patients aged 65 to 75 years old have no risk factors, they should be treated with aspirin in preventing stroke .For the older patients older than 75 years old and patients have risk factors, they should be treated with warfarin,which is more efficient than asprin in preventing stroke.

The synapsins are a family of neuron specific phosphoproteins associated with the membranes of synaptic vesicles. The synapsins play important roles in the neurotransmitter release and during the early neuronal development. In this review, we focus on the family members, gene location, distribution, structure and function of the synapsins.

Neurology is an important clinical course. Because of old teaching contents,laggard teaching mode and single teaching goal,the students can not apply after learning neurology course. The curriculum reform of neurology should be carried out under the teaching thoughts of ‘student-centered and competency-based’,to make creation and development in teaching content,teaching style and teaching mode and so on,so as to complete teaching mission better.

Objective To investigate the efficacy and safety of levosimendan on patients with acute left heart failure in acute myocardial infarction.Methods Thirty patients with acute left heart failure in acute myocardial infarction were selected and treated with an initial loading dose of levosimendan of 0.05 μg/(kg · min),followed increasing dose to 0.20 μg/(kg · min) for 24 h after no adverse reactions were observed.Clinical assessment was performed to evaluate efficacy and safety of levosimendan.Results The scores of dyspnea before medication was (1.95 0.71),(1.49 ±0.56) scores at 24 hours after medication and (1.15 ±0.51) scores at 1 week after medication group,and the differences were significant(F =3.346,P=0.043).The scores of clinical manifestation was also different among before medication group ((1.87 ±-1.21) scores),24 hours after medication group((1.36 ± 0.61) scores) and 1 week after medication group ((1.09 ± 0.58) scores,F =5.203,P =0.024).After 1 week medication left ventricular ejection fraction (LVEF),stroke volume (SV) and plasma NT-proBNP had significant difference with before medication group (LVEF:before medication group:(30.41 ± 5.62) ％,1 week group:(43.16 ± 8.51) ％,t =2.238,P =0.037 ;SV:before medication group:(59.52 ± 25.23) ml,1 week group:(72.31 ± 14.91) ml,t =2.067,P =0.047 ;BNP:before medication group:(2 534.56 ± 1 570.23) rng/L,1 week group:(934.32 ± 421.53) ng/L,t=2.347,P =0.020).No severe adverse effects were seen during the course of medication,while the common adverse effects including palpitations,dizziness,hypotension and ventricular premature beats were remission after treatment.Conclusion Levosimendan treatment on acute myocardial infarction,heart failure is proved to be an efficacy,safety,and well tolerated.