Health Promotion ; methods ; Humans ; National Institute for Occupational Safety and Health (U.S.) ; Occupational Health ; United States

Abdominal compartment syndrome(ACS)is an important factor contributing to the multiple organ dysfunction syndrome which is commonly seen in patients with severe acute pancreatitis(SAP).As a life-saving procedure,decompressive laparotomy is widely applied to patients with SAP complicated with ACS,especially to patients with edema of the visceral tissues caused by massive fluid resuscitation at the early stage of the disease.However,decompressive laparotomy should be adopted with caution since it is associated with enteroatmospherie fistula,intraabdominal infection,postoperative ileus,third space losses,hypothermia and hemia.Therefore,decompressive laparotomy should only be considered after conservative management had failed.The indications for decompressive laparotomy are as follows:(1)intraabdominal pressure＞25 nnn Hg;(2)adequate ventilation of the patient is difficult;(3)pereutaneous drainage of ascites is not helpful.Timely temporal abdominal closure is helpful in preventing complications.Infected peripanereatie necrosis is the indication for peripancreatic exploration or necroseetomy.A thorough knowledge of decompressive laparotomy is essential for individualized management of patients with SAP complicated with ACS.

Altering the natural history of disease has been the goal of medical therapy for Crohn's Disease (CD) in recent years. The conventional approach has been thestep-up therapy. With the introduction of biological agents (such as infliximab) , there is growing evidence that the top-down approach is justified in a subgroup of high-risk patients. The new algorithms is not only associated with superior clinical remission rates, but also may have the potential to alter the natural history of the disease, including inducing mucosal healing, reducing the rate of complications, surgeries and mortality. Further study will have to determine which subgroup of patients will benefit most from this early aggressive biological therapy approach.

Autonomic nerve dysfunction is common after onset of ischemic stroke.Heart rate variability (HRV) has been used widely because of the regulation effect of heart rate by the quantitative analysis of the autonomic nervous system.This article reviews the evaluation method of HRV and its clinical significance in ischemic stroke.

A rapid, novel spectrofluorimetric method to determine epristeride (EP) in biological fluids and a pharmaceutical formulation was developed, based on the fact that fluorescence intensity of L-tryptophan could be quenched by EP in the medium of pH ? 9.0. The various factors influencing fluorescence quenching were discussed. The quenching mechanism was investigated with the quenching type, synchronous fluorescence spectra and quantum efficiency. Under the optimized conditions, fluorescence quenching value (ΔF ? FL-tryptophan-FEP-L-tryptophan) showed a good linear relationship with the EP concentration ranging from 0.4 to 12.0μg/mL. The linearity, recovery and limit of detection demonstrated that the proposed method was suitable for EP determination in biological fluids and EP tablets. The method was successfully applied to the analysis of EP in real samples and the obtained results were in good agreement with the results of the official method.

Objective To detect neurotransmitters function in the brain and the brain functional index of outpatients with methadone maintenance treatment,and understand the change features of brain function.Methods Collect brain electrical power signals were collected from 58 outpatients with methadone maintenance treatment (MMT) and 44 healthy adults,and the correlations between the power of the neurotransmitters and the brain functional status were analyzed.Results (1) In MMT group,all neurotransmitters were lower generally than those in the control group,and the differences of GABA ((17.73±3.54) μV2 vs.(121.48±44.64) iμV2,P＜0.01),Glu ((42.18±12.84) μV2 vs.(105.31 ± 34.95) μV2,P＜0.05) were significant.(2) The relative powers of GABA ((17.10±51.72) μV2 vs.(78.67± 10.93) μV2,P＜0.001) and Glu((30.48±21.61) μV2 vs.(69.23±42.26) μV2,P＜0.001) reduced significantly,while 5-HT((297.18±31.54) μ V2 vs.(280.18±31.54) μV2,P＜0.01),ACh ((235.08±37.72) μV2 vs.(217.23±40.60)μV2,P＜0.05),NE((164.11±33.05) μV2 vs (146.39±30.80) μV2,P ＜0.01),DA((98.87±22.48) μV2 vs.(91.49±21.04)μV2,P＜0.05) rised significantly in MMT group.(3)The global power was lower((1012.01± 195.09)μV2 Vs.(1775.94±458.99) μV2,P＜0.01),and the excitement-inhibition index(2.19± 1.46 vs.0.99±0.47,P＜0.001) and the relative entropy((89.45±9.71) ％ vs.(75.48±9.97) ％,P ＜0.01)were higher than those in the controls.(4) In MMT group,there were positive correlation between all neurotransmitters and global power,as well as that between Glu and excitement-inhibition index (r=0.264,P＜0.05),NE and Vasomotor index(r=0.269,P＜0.05),but negative correlation between relative entropy and 5-HT(r=-0.276,P＜0.05) as well as DA(r=-0.375,P＜0.01)significantly.Conclusion The brain function of outpatients with MMT are lower than the normal significantly,and there are clearly imbalance between the excitement and inhibition among the brain neurotransmitters.

Altering the natural history of disease has been the goal of medical therapy for Crohn's Disease(CD) in recent years.The conventional approach has been the "step-up" therapy.With the introduction of biological agents (such as infliximab),there is growing evidence that the "top-down" approach is justified in a subgroup of high-risk patients.The new algorithms is not only associated with superior clinical remission rates,but also may have the potential to alter the natural history of the disease,including inducing mucosal healing,reducing the rate of complications,surgeries and mortality.Further study will have to determine which subgroup of patients will benefit most from this early aggressive biological therapy approach.

With the increasing understanding of the pathogenesis of Crohn's disease and the advent of biological therapy,the therapeutic strategies of Crohn's disease have changed a lot in recent years.In this review,we concerned the progress in the management of active disease,maintenance of medically induced remission,and surgical options of Crohn's disease.The new concept of "top-down" approach to the treatment of Crohn's disease evolved recently was also discussed.

Objectives To summarize the clinical features and relevant factors of 203 cases with infantile pulmonary tuberculosis. Methods Clinical data of 203 infantile with pulmonary tuberculosis were retrospectively reviewed. Results Among 203 infants, 127 (62.6%) were from country, 76 (37.4%) from city;64.5%of city infants have received BCG vaccination, which is higher than 46.5%in country infants;78 cases (38.4%) have clear evidence for active tuberculosis exposure, 26 cases (12.8%) have suspicious tuberculosis exposure;175 cases (86.2%) have fever, 165 cases (81.3%) have respiratory symptoms, 107 cases (52.7%) have pulmonary signs, 80 cases (39.4%) have hepatosplenomegaly;Etiology was conifrmed in 91 cases (44.8%);54.7%of patients were found with concurrent extrapulmonary tuberculosis, and the most commonly seen was formis tuberculous meningitis. In this study, the misdiagnosis rate is 39.9%, and 84.0%patients were often misdiagnosed as bronchial pneumonia;Vaccinated BCG rate is lower in infants with severe tuberculosis (44.83%) than that of infants with mild tuberculosis (74.14%). Conclusions Infantile pulmonary tuberculosis is featured with acute onset, severe clinical performance and easily complicated with extrapulmonary tuberculosis, atypical clinical performance, and high misdiagnosed rate which needs early detection and diagnosis. Unvaccinated BCG and active tuberculosis exposure were important clues for the diagnosis of infantile pulmonary tuberculosis.

To clarify the progress of the study on the quality of Chinese medicine dispensing granules,and to provide reference for its further development and application.Referring to the relevant literature about the quality control of Chinese medicine dispensing granules,the main quality control methods,the quality and efficacy of traditional pieces,and the quality of traditional Chinese medicine extracts were analyzed and summarized.At present,the main methods of quality control ofTCM dispensing granule are high performance liquid chromatography and mass spectrometry,infrared spectroscopy.Compared with the traditional decoction and extract of TCM dispensing granule and traditional Chinese medicine composition,quality and effect of each has advantages and disadvantages,it needs further study.This paper reviewed the progress of quality control of Chinese medicine dispensing granules in recent years,and provided a reference for further research and development.