Objective To discuss the reasonable utilization of β-lactam antibiotics in patients with renal failure on hemedialysis. Methods The clinical characteristics of patients with renal failure on hemodylysis,who de-veloped the adverse effect of nervous system and psychiatric symptom while being treated with β-lactam antibiotics,were retrospectively analyzed. Results The adverse effect of nervous system and psychiatric symptom showed dur-ing and after hemodialysis,including: mental confusion,hyperexcitabiliy,incoherent speech,lethargy and amyestasia in two cases. Physical examination did not show signs of cerebral focal injury in all cases. Computed tomography of brain in 7 patients did not show acute lesions. The symptoms completely disappeared after withdrawal of β-lactam antibiotics but bemodialysis or hemodiafiltration continued. Conclusion β-lactam antibiotics used in conventional dose could cause temporary adverse effect of nervous system in patients with renal failure on bemodialysis,which is related to prolongation of drug half life.

Objective To investigate the consultative status of patients with Alzheimer Disease (AD), and to evaluate the efficacy and safety of donepezil (Aricept) in the treatment of AD.Methods This survey was initiated by Chinese society of Geriatrics, and was sponsored by Eisai (China) Inc. It was conducted in 60 hospitals of 40 cities in China. The diagnosis of dementia was made according to ICD-10 and DSM-Ⅳ criteria. The cognition, behavior and ability of daily living of the patients were compared before and after 3-month treatment with donepezil. Results A total of 808 dementia patients were recruited. The main reasons for patients' seeing doctors included memory problem (n= 703, 87%), behavioral and psychological symptoms (n= 250, 31%), impairment of ability of daily living (n= 388, 48% ). The disease course was from 9 months to 16 months, and mean disease course was (13.0 ±0. 2) months. Patients mainly sought treatment from neurologist (74 % ),psychiatrist (6 % ) and geriatrics ( 19 %). They received dementia diagnosis at ( 14.4 ± 0.3) months after their dementia symptoms appeared. Treatment with donepezil for three months improved their cognition, ability of daily living and mental condtion (all P＜0.05). The main adverse effects were nausea, vomiting etc. Conclusions In China, the percentage of people with dementia seeking treatment is low. Most people with dementia see doctors when they reach moderate and severe stages,which affects the efficacy of treatment and daily activity of the patients. Treatment with donepezil for 3 months is effective in improving cognition, behavior and activity of daily living.

Objective:To discuss the regulation requirements of software based on the analysis of software-related recalls of medical devices. Methods:The data of software-related recalls of medical devices in America were collected and processed, and the type, situation, cause and trend of software-related recalls were analyzed, then the suggestions on the regulation requirements of software were proposed. Results:During the four periods from 1983 to 2011, the percentage of software-related recalls vs medical device recalls in America increased from 6%to 19%, and the year-on-year growth rate of software-related recalls rose by 47%to 164%, significantly higher than medical device recalls in the same period (from 13%to 54%). Especially, the problem of software-related recalls in radiology medical devices was the most serious. Conclusion: The regulatory situation of software is more complicated and severe, so the regulation requirements of software, including software validation, adverse event monitoring and usability design, need to be further strengthened according to the particularity of software.

Objective To investigate the protective effects of dexmedetomidine on myocardial injury of severe burn patients. Methods Seventy-eight cases of severe burn patients were enrolled in this study in our hospital from May 2014 to May 2016. According to the clinical characteristics of treatment, the patients were divided into the control group and the observation group, with 39 cases in each group. Patients in the control group were treated with midazolam sedation on the basis of conventional burns, and patients in the observation group were treated with dexmedetomidine combined with midazolam sedation. The myocardial function-related indicators, heart rate (HR) and mean arterial pressure (MAP) of patients were compared between the 2 groups after treatment. Results (1) The SOD, MDA, CK-MB, cTnI and TNF-αof the two groups after treatment were significantly lower than those before treatment, and the degree of reduction in the observation group was significantly higher than that in the control group (P<0.05);(2) There were significant changes in MAP and HR before and after treatment in the both 2 groups. The decrease s of HR and the degree of MAP elevation in the observation group were significantly higher than those in the control group (P < 0.05, respectively). Conclusions Dexmedetomidine can improve the SOD activity of patients with severe burns, and the decreased expressions of CK-MB, cTnI and TNF-αcan reduce the degree of damage to myocardial tissue microstructure, and can protect the myocardium of patients with severe burns.

Objective:To explore the multiple meditation effects of emotional intelligence and self-esteem between interpersonal initiative personality and social positive adaption in left-behind junior high school students.Methods:Totally 331 left-behind junior high school students [165 boys,160 girls,average age of (14.5 ± 1.2) years] were selected.They were assessed with the Interpersonal Self-Support Scale for Middle School Students (ISSS-MSS),Emotional Intelligence Questionnaire (EIQ),Rosenberg Self-Esteem Scale (RSES) and Social Adjustment Scale (SAS-YB).Results:The scores of social positive adaption were positively correlated with the scores of interpersonal initiative personality,EIQ and RSES (r ＝ 0.47-0.67,Ps ＜ 0.001).Path analysis showed that interpersonal initiative personality had direct effects on social positive adaption (β ＝ 0.47,P ＜0.001).Mediation modeling showed that interpersonal initiative personality could exert effects on social positive adaption indirectly through the mediating effect of not only emotional intelligence,but also self-esteem (x2/df＝ 3.03,TLI ＝ 0.87,CFI ＝ 0.89,RMSEA ＝ 0.08).Conclusion:The present study indicates that parallel multiple mediation model of emotional intelligence and self-esteem could explain the mechanism of influence of interpersonal initiative personality on social positive adaption appropriately.

Short stature accounts for a large proportion of endocrine diseases in children,with a complex and cross-cutting etiology. It is one of the risk factors for physical and psychological problems in children,and needs proper diagnosis and timely treatment. The insulin-like growth factor-1 ( IGF-1 ) generation test is via re-combinant human growth hormone(rhGH)stimulating peripheral target cells to secrete IGF-1. The effects of rh-GH stimulation are then evaluated according to the responsiveness of IGF-1,which is not only helpful for further determination of clinical classification of short stature,but also for therapy assessment of rhGH in time and a-chievement of personalized treatment.

Objective To understand the development status of healthcare-associated infection (HAI)management organizations in Xinjiang region,and effectively improve the management level of HAI in Xinjiang.Methods 101 secondary and above medical institutions in Xinjiang were selected by cluster random sampling method,a retrospec-tive survey was conducted from February 15 to March 31,2016.Development of HAI management organizations in each hospital in 1995,2000,2005,2010,and 2015 were surveyed,statistical analysis of the surveyed results were conducted.Results Of 101 hospitals,22 were tertiary hospitals,79 were secondary hospitals.In 2005 and before, more than 70% of hospitals with >300 beds and 20% of hospitals with< 100 beds carried out HAI management, about 50% of hospitals with >300 beds and less than 5% of hospitals with< 100 beds set up HAI management committees.In 2015,all hospitals carried out HAI management and set up HAI management committees as well as HAI management departments.In 2005 and before,the main HAI management professionals were nursing staff, accounting for about 80%;in 2000 and before,> 50% of full-time professionals received secondary vocational school and below education,in 2005 and after,about 80% of full-time professionals received at least college and above education;in 2000 and before,> 70% of full-time professionals didn’t receive training.In 2015,the percentage of nursing staff engaged in HAI management dropped to 65.90%,and doctors and other professionals both accounted for 17.05%,40.09% of HAI management professionals received university education,92.08% par-ticipated in autonomous region level and above training,1.98% didn’t receive training.Conclusion HAI infection management organizations in Xinjiang region in the past 20 years have developed,the allocation of professionals and professional quality can not meet the needs of HAI infection management in this region.

As pattern recognition receptors of innate immunity,Toll-like receptors (TLRs) play an important role in the identification of pathogens,regulation of adaptive immunity and signal transduction.With more exploration of the mechanism of microbial keratitis and the acute or chronic rejection after penetrating keratoplasty,the induction and regulation of TLRs on the corneal immune response is increasingly concerned.Up to now,more and more studies of immune signal pathway of TLRs in mediating inflammatory response of bacterial keratitis,fungal keratitis,viral keratitis and graft rejection have been documented.To regulate the expression of TLRs is undoubtedly available for lightening and arresting the immuno-inflammatory response.Here,the current knowledge about TLRs,their signal transduction pathway and their regulation on corneal immunity are summarized,aiming to discuss their significant effects and the potential therapeutic targets.

AIM: To observe the changes in contrast sensitivity (CS) between emmetropic pilots, glasses wearing, and after laser in situ keratomileuses ( LASIK) surgery pilots, provide the basis for the physical examination standard after operation.
METHODS:The CS of 13 emmetropic pilots (26 eyes), 12 glasses wearing pilots (24 eyes) and 10 with LASIK (20 eyes) , under photopic, scotopic and scotopic with glare environments at four different spatial frequencies ( 3, 6, 12 and 18cpd ) were measured and the resluts were analyzed by statistics.
RESULTS:Under photopic environments, there was no significant difference in the low spatial frequency (3cpd) among the three groups (P>0. 05). The CS of emmetropic pilots was better than that of the myopic and with LASIK, and there was significant difference (P<0. 05). There was no significant difference in CS between myopic and with LASIK (P>0. 05). Under scotopic environments, there was no significant difference in the low spatial frequency (3cpd)among the three groups (P>0. 05). The CS of emmetropic and with LASIK pilots were better than that of the myopic, and there was significant difference ( P<0.05). There was no significant difference in CS between emmetropic and with LASIK (P>0. 05). Under scotopic with glare environments, the CS of emmetropic and myopic pilots were better than that of the with LASIK, and there was significant difference (P<0. 05). There was no significant difference in CS between myopic and with LASIK (P>0. 05).
CONCLUSION: The CS after LASIK is decreased compare with emmetropic pilot, specially under scotopic with glare environments. A perfect identification standard should be set up.

Objective To explore the clinical value of double collagenase injection in treating patients with lumbar disc herniation. Methods Thirty one patients with lumbar disc herniation to whom DCI had been applied were analyzed with 15 to 31 months follow-up. Results The therapeutic effects were excellent in 27, good in 3, fail in 1. The total effective rate was 96.7%.Conclusions DCI is a good method in treating lumbar disc herniation with high effectiveness, extensive indications, low complications and profitable clinical application prospectively.