Neurological complications of viral hepatitis mainly include hepatic encephalopathy,hepatic myelopathy,peripheral neuropathy,meningoencephalitis,and epilepsy.Hepatic encephalopathy is a common complication with mature diagnosis and treatment methods,and the other complications are relatively uncommon and lack treatment methods.This article introduces the classification,clinical manifestation,and treatment of each complication,in order to find the optimal therapies for neurological complications of viral hepatitis.

〔Abstract〕 The paper briefly introduces the concept and development process of Electronic Medical Records ( EMR) , elaborates in-formation extraction of EMR as well as the methods assisting clinical decision, including machine learning, statistical learning and rule induction, etc.It describes the application of EMR assisting clinical decision in diagnostic criteria identification and clinical diagnosis ac-tivities, reflects its evidence-based significance.

Objective To evaluate the applicative value of ultrasound elastography in diagnosis of focal lesions in the parotid and submandibular glands.Methods 30 patients(30 lesions) were scanned by real-time ultrasound elastography and were analyzed in elastography evaluated criteria (5 score method).All the results were compared with the pathological types.Results The elastographic grades of most benign nodules were 1 - 3,while most of malignancy were 4 - 5.The elastographic grades of benign and malignant lesions were of significant difference statistically( P ＜0.01 ).If elastographic grade 4 or 5 were diagnosed as malignancies,the sensitivity,specificity and accuracy for diagnosing malignant l(e)sions in the parotid and submandibular glands were 72.73 ％,84.21 ％,80.00 ％,respectively.Conclusions Ultrasound elastography is useful in the differential diagnosis of focal lesions in the parotid and submandibular glands.

Objective To examine the single nucleotide polymorphism(SNP) of apurinic/apyrimidinic endonuclease1 (APE1) in primary small cell carcinoma of esophagus(PSEC) ,then investigate the relationship between these SNPs and the prognosis.Methods Sixty cases first-treated patients with PSEC were recruited, patients with esophageal squamous cell carcinoma (ESCC) and healthy blood donors were recruited as positive and negative controls.APE1 (Asp148Glu) of the patients with PSEC and controls were genotyped by the TaqMan method.Every patient was treated with platinum-based chemotherapy(EP regimen for PSEC and TP regimen for ESCC)and radiotherapy(3D-CRT) ,then every case was followed-up for 2 years.The relationship between these SNPs and the follow-up outcome was analyzed.Results Compared with the ESCC group and control group, APE1 148 pure mutant(Glu/Glu) of PSEC group increased significantly(PSEC group was 40％ (12/30), ESCC group was 13.3％ (4/30) , control group was 10％ (2/20)), the difference was statistically significant (x2 =7.248,P =0.027).According to data of following-up, there was a significant increase in rate of progress (1year:40.0％ (12/30) vs 16.7％ (5/30), x2 =4.022, P =0.045;2 years: 86.7％ (26/30) vs 40.0％ (12/30) ,P =0.004) and a significant decrease in survival (33.3％ (10/30) vs 76.7％ (23/30)) of PSEC compared with ESCC.The SNPs of APE1 Asp148Glu was significantly correlated with frequency of progress, a significant increase was found in rate of progress of the patients with mutant type(Asp/Glu±Glu/Glu) compared with wild genotype(1 year: 50.0％(11/22) ,x2 =3.854,P=0.05;2 years: 81.8％ (19/22) ,x2 =10.519,P =0.001) ,the survival of the patients with mutant genotype was significantly lower than wild type (22.7％ (5/22) ,x2=10.77,P=0.001).Conclusion The most of polymorphisms of APE1(Asp148Glu) are mutation type in PSEC.Pure mutant genotype (APE1 148Glu/Glu) carry significant enhancement of progression.The polymorphisms of APE1 (Asp148Glu) maybe one of those molecular mechanisms of high frequency of progress and poor prognosis in PSEC.

Objective To explore the role of clinical pharmacist in individualized treatment of hypertension.Methods A patient withH hypertension receiving pharmaceutical care from clinical pharmacists was retrospectively analyzed.Results Patient's MTHFR (C677T) gene type was TT homozygous.Clinical pharmacist suggested doctor modify treatment,and then patient's plasma homocysteine dropped from 61.5 to 16.0 μmol·L-1,and blood pressure dropped from 173/ 111 mmHg(1 mmHg =0.133 kPa) to 130/80 mmHg.Conclusion Clinical pharmacist provides individualized treatment for patient with hypertension to ensure the safety and effectiveness of the drug by genotyping.

Objective To study the influence of Compound Salvia injection combined with cefoperazone sulbactam sodium on renal function and renal interstitial fibrosis in elderly patients with chronic pyelonephritis (CPN).Methods From April 2013 to July 2014, 126 cases of CPN were divided into observation group ( n =63 ) and control group ( n =63 ) according to the order of admission to hospital.All patients were given cefoperazone sulbactam sodium, and patients in observation group were added Compound Salvia injection.The clinical efficacy of treatment were evaluated between two groups, renal function and TGF-β1 were observed and compared before and after treatment in two groups.Results After treatment, HE staining of nephridial tissue showed renal interstitial fibrosis in observation group obvious improved more.The overall response rate of observation patients (90.48%) was significantly higher (74.60%) than control group, and the relapse rate of observation group (1.59%) was significantly lower than control group (14.29%), and there were statistically significant differences (P<0.05).After treatment, urinary albumin (11.4 ±3.1) mg/L, BUN (5.7 ±0.5) mmol/L, and Scr (103.2 ±10.4)μmol/L of observation group were significantly lower than control group, respectively (P<0.05).After treatment, TGF-β1 level (103.4 ±32.5) ng/L of observation group was significantly lower than control group (202.4 ±35.2) ng/L(P<0.05).There was no significant difference in adverse reactions between two groups.Conclusions Compound Salvia injection combined with cefoperazone sulbactam sodium has good efficacy.can significantly improve renal function, delay renal interstitial fibrosis in treatment of elderly patients with chronic pyelonephritis.

Objective To investigate the influence of three kinds of different Ca~(2+) concentration of dialysate on serum calcium,calcium-phosphorus product,serum PTH and CRP in maintenance hemodialysis patients.Methods 45 patients of maintenance hemodialysis with ages ≥18 years were selected.They were divided randomly three groups,and be given three different kinds of Ca~(2+) concentration of dialysate to carry out hemodialysis with 3 months.Then the patients' variation of blood pressure and whether there were low calcium spasm or ostealgia were abserved during hemodialysis whole range.In addition,changes of their serum calcium、phosphorus、iPTH and CRP at pretherapy and three months after reatment were also detected.Results After three months of hemodialysis,serum iPTH in patients with low Ca~(2+) concentration dialysate increased obviously,and the serum CRP decreased significantly(P0.05),and serum CRP increase notably(P

A total of 62 critically ill patients were randomly allocated to the intensive insulin therapy group and the conventional insulin therapy group. The effect of therapy on the prognosis, the activity of NF-κB in peripheral blood monouclear cells and plasma intercellular adhesion molecule-1 level were investigated. The results showed that the intensive insulin therapy may improve the prognosis and insulin had a reliable anti-inflammatory effect in the critically ill patients.

Aim To study the effect of simvastatin on ventricular remodeling in rats after myocardial infarction,and the association between this effect and phosphorylating extracellular signal-regulated kinase1/2(p-ERK1/2).Methods Myocardial infarction(MI)rat models were successfully induced by ligation of anterior descending coronary artery.The treated rats were randomly divided into 4 groups(n=8~10):MI only group,MI plus 20 mg Sim group(20 mg?kg-1?d-1),MI plus 40 mg Sim group(40 mg?kg-1?d-1),and sham-operated group.After 4 weeks,the rats were checked by echocardiography including LVEDd,LVPWd,LVEF,FS,SV and CO.Myocardial p-ERK1/2 was also examined by immunohistochemistry and Western blot.Results Compared with sham-operated group,LVEDd,LVPWd in other groups were significantly increased(P

Post-stroke aphasia refers to acquired language disorder caused by cerebrovascular disease.As part of cognitive function,language is closely related with other non-linguistic cognitive function.In recent years,many scholars have begun to pay attention to the relationship between language disorder and non-verbal cognitive function in patients with post-stroke aphasia.This paper describes the epidemiology of cognitive impairment in patients with post-stroke aphasia,and summarizes the relationship between language obstruction and the non-language-based cognitive function in patients with aphasia after stroke (such as working memory,attention,execution,etc.) to provide a direction for further research.