The paper firstly introduces the research status of autism and analyzes the gap between China and the US in autism net-work service, proposes using the mainstream socialized Q&A community data in foreign countries to construct an autism Q&A knowledge base.It introduces data collection, management, service process and key issues of the knowledge base and gives application examples of the knowledge services.Construction of this knowledge base can provide targeted and valuable knowledge services to users and can help enhance the retrieval efficiency.

Objective To investigate the differences of the plasma homocysteine (Hcy) between the patients with acute cerebral infarction and the normal controls, and the relationship between the levels of plasma Hcy and folic acid, vitamin B_(12) and lipids, and the relationship between clinical symptoms in patients with acute cerebral infarction. Methods A total of 91 patients with first-ever acute cerebral infarction and 100 controls without cerebrovascular accident were included. Their ratio factors such as age, sex, hypertension and diabetes did not have significant differences. Enzymatic cycling was used to detect plasma Hcy levels. Chemiluminescence was use to detect folic acid and vitamin B_(12) levels. Biochemical analyzer was used to measure lipid levels. The patients with acute cerebral infarction were evaluated by the National Institutes of Health Stroke Scale (NIHSS). Results The plasma Hcy level was significant higher in the acute cerebral infarction group than that in the control group (21.22 ±7.29 μmol/L vs. 13.19 ± 2.13 μmol/L) (P ＜ 0.05); the plasma Hcy level in the acute cerebral infarction group was significantly negatively correlated with folic acid (r = - 0.307,P ＜0.05) and vitamin B_(12) (r = - 0.270, P ＜0.05). It was significantly positively correlated with low-density lipoprotein (r =0.282, P ＜0.05), and it was significantly negatively correlated with high-density lipoprotein (r = -0.219, P ＜0.05). The mean value of the plasma Hcy in acute cerebral infarction group increased with the increase of NIHSS scores. Conclusions Hyperhomocysteinemia is an independent risk factor for acute cerebral infarction. The levels of folic acid and vitamin B_(12) decreased with the increase of Hcy levels. The higher the Hcy levels,the more serious the clinical symptoms are. Hcy may increase the risk of ischemic cerebrovascular disease by influencing the lipid metabolism.

OBJECTIVE: To compare the effects of bupivacaine, lidocaine and saline injections in alleviating post tonsillectomy pain. METHOD: We recruited 60 patients into the study. All subjects were randomly allocated into 3 groups. Group 1 received 0.9% sodium chloride (saline group), group 2 received 0.25% bupivacaine (bupivacaine group) and group 3 received 2% lidocaine (lidocaine group), infiltrated around each tonsil. Pain was evaluated with McGrath's face scale. RESULT: The postoperative pain scores at 2 and 6 hours were similar among the groups (P>0.05). The pain scores in the bupivacaine group were lower than those in the saline group at 12 h (P<0.05). The pain scores in the bupivacaine and lidocaine groups were significantly lower than those in the saline group from 18 to 24 hours until day 7 (P<0.05). There was no difference between the bupivacaine and lidocaine groups (P> 0.05). CONCLUSION Local infiltration of bupivacaine is a relatively and safe effective method and is equivalent to use of lidocaine for post tonsillectomy pain.
Analgesia ; methods ; Bupivacaine ; Child ; Child, Preschool ; Female ; Humans ; Lidocaine ; Male ; Pain Measurement ; Pain, Postoperative ; prevention & control ; Snoring ; surgery ; Tonsillectomy

Objective:To observe the clinical effect of self-prescribed Zuoyu No. 2 (ZY2) in the treatment of anal eczema after complex anal fistula operation. Methods: Totally 100 patients were randomly divided into two groups, the patients in the treatment group were given ZY2 combined with the conventional wound dressing treatment after defecation everyday, while the patients in the con-trol group were treated with washing infection area with warm water followed by applying triamcinolone acetonide and econazole creams on the lesion or itching skin combined with the conventional wound dressing after defecation everyday. Results:The efficiency rate in the treatment group was higher than that in the control group (82. 0% vs 60. 0%, P<0. 05), the total effective rate in the treatment group was also significantly higher than that in the control group (100% vs 90. 0%, P<0. 05). The anal pruritus disappearance time and the skin lesion recovery time in the treatment group were better than those in the control group(P<0. 05). Conclusion:ZY2 has a good clinical curative efficacy in the treatment of anal eczema after complex anal fistula operation with improvement of clinical symp-toms, which is worthy of promoted application.

The zinc chloride and cystine resistant strain of S.cerevisiae YZM-14(ZnCl2r,Cysr) was screened with the mutant processing of the protoplast of S.cerevisiae by combinative mutagens of ultraviolet and nitrite.The glutathione(GSH) production(84.72 mg/L),dry cell weight(7.63 g/L) and the intracellular GSH content(11.10 mg/g) of YZM-14 were 2.79,1.63 and 1.71 times compared with that of the initial strain.The biosynthetic process of GSH was divided into three phases according to the time course of the specific cell growth rate and GSH yielding coefficient.In the second phase,the metabolic flux of the pentose phosphate pathway and the GSH precursors biosynthetic pathway of the mutant strain increased by 8.1 mmol/(g?h),compared with that of the initial strain.Furthermore,the metabolic flux of the organic acids secretion of the mutant strain decreased.Through these mechanisms,the utilization efficiency of the carbon sources was enhanced and high production of GSH was obtained.

Objective To investigate the effectiveness of target-controlled infusion (TCI) of etomidate and remifentanil for endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA).Methods Sixtynine ASA Ⅰ or Ⅱ patients of both sexes,aged 35-71 yr,weighing 41-83 kg,scheduled for elective EBUS-TBNA,were randomly divided into 3 groups ( n =23 each).In group Ⅰ,anesthesia was induced with TCI of propofol and iv injection of fentanyl 4 μg/ml,and the target plasma concentration (Cp) of propofol was set at 3-4 μg/ml.In group Ⅱ ,anesthesia was induced with TCI of propofol ( Cp 3-4 μg/ml) and remifentanil ( Cp 5 ng/ml).In group Ⅲ ,anesthesia was induced with TCI of etomidate (Cp 0.3-0.4 μg/ml) and remifentanil (Cp 5 ng/ml).After the patients lost consciousness,laryngeal mask airway was inserted to perform mechanical ventilation.PETCO2 was maintained at 30-40 mm Hg.BIS value was maintained at 40-60.The use of vasoactive agents (perdipine,ephedrine,atropine and esmolol) and occurrence of bucking during operation,emergence time,and the occurrence of nausea and vomiting within 24 h after operation were recorded.Blood samples were collected from the femoral vein at 30 min before induction,at the end of operation and at 24 h after operation for determination of the plasma cortisol concentration.Results The incidence of bucking and nausea and vomiting was significantly lower,the emergence time was significantly shorter,and the number of patients who needed vasoactive agents during operation was significantly smaller in groups Ⅱ and Ⅲ than in group Ⅰ ( P ＜ 0.05).The number of patients who needed vasoactive agents during operation was significantly smaller in group Ⅲ than in group Ⅱ (P ＜0.05).Compared with groups Ⅰ and Ⅱ,the plasma cortisol concentration was significantly decreased at the end of operation in group Ⅲ (P ＜ 0.05).There was no significant difference in the plasma cortisol concentration at each time point between groups Ⅰ and Ⅱ (P＞0.05).Conclusion TCI of etomidate (Cp 0.3-0.4 μg/ml) and remifentanil (Cp 5 ng/ml) can provide satisfactory anesthesia for EBUS-TBNA with few adverse effects.

Child ; Exostoses, Multiple Hereditary ; genetics ; Female ; Humans ; Mutation ; N-Acetylglucosaminyltransferases ; genetics ; Pedigree

Objective To evaluate the effect on inflammatory mediators and mechanism of dynamic factors on lung injury in a dog model of acute respiratory distress syndrome (ARDS). Method The ARDS dog model was duplicated by instillation hydrochloric acid. The dogs were randomly (random number) divided into six groups: (1) normal control group (N group); (2) ARDS group (M group); (3) low VT (6 mL/kg) at respiratory rate 30, low inspiratory flow 6 mL/(kg·s). (4) large VT (20 mL/kg) at respiratory rate 30, high inspiratory flow 20 mL/kg·s.(5) large VT (20 mL/kg) at respiratory rate 15, high inspiratory flow 17 mL/(kg·s). (6) large VT (20 mL/kg) at respiratory rate 15, low inspiratory flow 10 mL/(kg·s). All the dogs were killed after 4 h ventilation. TNF-α、IL-8, p38 MAPK and NF-κB activity in the lung were measured. Results The expression of IL-8 protein in B and C groups was much higher than that of other groups ( P < 0.01) . There was no significant difference among M, A and D groups (P > 0.05). The gray scale ratio of B group was obviously higher than that of other groups (P < 0.01), except C group (P > 0.05). There was no significant changes among M, A and D groups in TNF-α protein contents. p38 MAPK value of positive staining of B group was the strongest, significantlyhigher than that of D group ( P < 0.01) .The expression of p38 MAPK in B and C groups was much higher than other groups (P <0.01). NF-κB activity in B group (33.56±2.85%) was significantly higher than that in A (10.35±0.6%)、D(7. 11 ± 0.47%)group, but there was no difference between B and C group (30.87 ± 1.16%). Conclusions Ventilation at high tidal volume, high inspiratory flow rate, high respiratory rate could activate p38 MAPK and increase the activity of NF-κB with the result of aggravating the release of inflammatory mediators. p38 MAPK and NF-κB activation are the major mechanisms in the development of VILI.

OBJECTIVE To know the clinical antibacterial use by line category in pediatric outpatients and emergency departments.METHODS The antibacterial use by line category from the 38998 prescriptions of pediatric outpatient and emergency departments of a hospital from Jul 1st to Dec 31st 2008 according to the medicament amount and frequency were surveyed and analyzed.RESULTS First-line antibacterial drug DDDs accounted for 37.4% and 24.7% of the total amount;second-line drug DDDs accounted for 48.7% and 40.8% of the total amount and the third-line drug DDDs accounted for 13.9% and 35.0% of the total amount.The top three by total amount were cefmetazole sodium injection,azithromycin sodium injection and Cefuroxime sodium injection.According to the sorting method of DDDs,the top three were cefprozil dry suspension,azithromycin sodium injection and amoxicillin sodium clavulanate potassium injection.CONCLUSIONS Frequency of the third-line antibacterial drug using is relatively high.Clinicians have a tendency to skip a line category in using drugs.Effective measures should be taken to strengthen the management of antibacterials.

65yrs, diabetes mellitus, chronic renal failure, etc; of which 7 were independent risk factors associated with death (P