This paper reports the diagnosis and treatment of a case of lymphocytic hypophysitis in pregnancy complicated by intrahepatic cholestasis of pregnancy. The 32-year-old patient had regular menstrual cycles and conceived naturally. Around 24 weeks of gestation, she developed a headache without abnormalities in the visual field. Skin itching occurred at 32 weeks of gestation, but her headache was significantly relieved. By 33 +1 weeks of pregnancy, the patient experienced elevated total bile acid, transaminase, and hypoglycemia, leading to a diagnosis of intrahepatic cholestasis of gestation (mild). Subsequently, at 33 +6 weeks of gestation, her total bile acid increased substantially, and the disease progressed rapidly into intrahepatic cholestasis of pregnancy (severe). As a result, an emergency cesarean section was performed to terminate the pregnancy. The Apgar score of the newborn was five points at one minute and ten points at five minutes. Following the surgery, the patient showed no lactation and had symptoms such as nausea, vomiting, fatigue, and refractory hyponatremia. Blood hormone measurement showed hypopituitarism. An enhanced intracranial MRI showed pituitary enlargement and uniform enhancement. Consequently, the clinical diagnosis was lymphocytic hypophysitis. Treatment with glucocorticoids effectively alleviated the symptoms. Menstruation resumed after more than one month of delivery. The intracranial MRI in postpartum reexamination after six months of delivery revealed a disappearance of the lesion. The patient continued with oral glucocorticoid therapy.

Objective:To establish a disease risk prediction model for the newborn screening system of inherited metabolic diseases by artificial intelligence technology.Methods:This was a retrospectively study. Newborn screening data ( n=5 907 547) from February 2010 to May 2019 from 31 hospitals in China and verified data ( n=3 028) from 34 hospitals of the same period were collected to establish the artificial intelligence model for the prediction of inherited metabolic diseases in neonates. The validity of the artificial intelligence disease risk prediction model was verified by 360 814 newborns ' screening data from January 2018 to September 2018 through a single-blind experiment. The effectiveness of the artificial intelligence disease risk prediction model was verified by comparing the detection rate of clinically confirmed cases, the positive rate of initial screening and the positive predictive value between the clinicians and the artificial intelligence prediction model of inherited metabolic diseases. Results:A total of 3 665 697 newborns ' screening data were collected including 3 019 cases ' positive data to establish the 16 artificial intelligence models for 32 inherited metabolic diseases. The single-blind experiment ( n=360 814) showed that 45 clinically diagnosed infants were detected by both artificial intelligence model and clinicians. A total of 2 684 cases were positive in tandem mass spectrometry screening and 1 694 cases were with high risk in artificial intelligence prediction model of inherited metabolic diseases, with the positive rates of tandem 0.74% (2 684/360 814)and 0.46% (1 694/360 814), respectively. Compared to clinicians, the positive rate of newborns was reduced by 36.89% (990/2 684) after the application of the artificial intelligence model, and the positive predictive values of clinicians and artificial intelligence prediction model of inherited metabolic diseases were 1.68% (45/2 684) and 2.66% (45/1 694) respectively. Conclusion:An accurate, fast, and the lower false positive rate auxiliary diagnosis system for neonatal inherited metabolic diseases by artificial intelligence technology has been established, which may have an important clinical value.

Objective To summarize nursing methods of vacuum sealing drainage (VSD)for plastic surgery patients with skin flap necrosis.Methods VSD was applied to 4 plastic surgery patients with skin flap necrosis in Middle Second Ward of Plastic Surgery Hospital,Chinese Academy of Medical Sciences.The effectiveness of VSD was retrospectively summarized and analyzed.Results Two patients with intercostalartery perforator flap had been treated with VSD for two cycles.There were massive fresh granulation tissue characterized with fine granules,abundant capillaries and no edema.The area of wound had decreased to 2 cm × 2 cm.Moreover,the wound recovered well after skin-graft repairing. One patient with ectatic sensate paraumbilical flap had been treated with VSD for one cycle.The area of wound had decreased to 1 cm ×1 cm and recovered after four times dressing change.The last case of patient with scapular flap had been treated with VSD for 3 cycles and the area wound had decreased to 2 cm ×3 cm.The wound recovered favorably after skin-graft repairing.There were no systemic or local toxicity,allergic reaction and complications in all four cases. Conclusions Application of VSD,which is worth of clinical expansion,is a simple-handling and effective treatment for plastic surgery patients with skin flap necrosis after debridement.

ObjectiveTo observe the effect ofZuogui Jiangtang Jieyu Formula on the expressions of glutamate, NR2A and NR2B in hippocampus of diabetic rats with depression;To explore the mechanism of protective effect. Methods Diabetes with depression rat models were established and then were randomly divided into the model group, positive medicine group, high-, medium- and low-doseZuogui Jiangtang Jieyu Formula groups. Normal rats acted as normal group, 16 rats per group. After 28 days of administration, Open-field test was used to detect the behavior of the rats;glutamate content of hippocampus was detected by ELISA;the expressions of NR2A and NR2B in rat hippocampus were detected by immunofluorescence.Results Compared with normal group, automatic activity times of rats in model group decreased significantly (P<0.01);both glutamate content (P<0.01) and expressions of NR2A, NR2B (P<0.01) increased significantly. Compared with the model group, automatic activity times of rats in positive medicine group and high-doseZuogui Jiangtang Jieyu Formula group significantly increased (P<0.01);glutamate content dropped (P<0.01);expressions of NR2A and NR2B decreased (P<0.05).ConclusionZuogui Jiangtang Jieyu Formula can improve depressive behavior of diabetic rats with depression, which may be related to the regulation of glutamate content and expressions of NR2A and NR2B in hippocampus.

PurposeTo analyze the far infrared thermography characteristics before and after surgery in patients with acoustic neuroma.Materials and Methods Thirty-two patients with acoustic neuroma were included as observation group and 40 normal healthy individuals as control group. Un-cooled thermal imaging system (ATIR-M301B) was used with working temperature of 20-25℃. Craniofacial infrared images were collected to analyze temperature differences among different detection zones.Results Far infrared thermography revealed that there were no obvious temperature differences between both sides of supraorbital region, endocanthion region, frontal region and buccal region in the control group (P>0.05). The temperature differences in bilaterally symmetrical parts of supraorbital region, endocanthion region, frontal region, buccal region were significantly higher in observation group (t=1.557, 1.714, 1.483 and 1.569,P<0.05). The craniofacial temperatures of 32 patients changed after operation, and the differences reduced in supraorbital region, endocanthion region, frontal region, and buccal region (t=2.655, 2.462, 2.897 and 4.465,P<0.05).Conclusion Far-infrared thermography inspection can detect abnormal temperature changes.

Objective To evaluate the efficacy and safety of sorafenib in the treatment of advanced renal cell carcinoma.Methods The clinical date of 33 patients with advanced renal cell carcinoma from September 2007 to April 2012 was reviewed retrospectively.26 were males and 7 were females,with an average age of 69 years.Pathological diagnosis showed 30 clear cell RCCs,2 papillary RCCs,and 1 unclassified RCC.These patients were treated by sorafenib 400 mg twice a day until intolerable toxicity or disease progression.The primary end points were objective response rate,clinical benefit rate,median survival time,median progression-free survival and the incidence of adverse reaction.Results All patients were evaluable for response and toxicity,with 8 patients (24％) of partial remission,19 cases (58％) of stable disease,and 6 cases (18％) of disease progression.The disease control rate was 82％,the median progression-free survival was 10.2 months,while the median survival time was 16.5 months.The common adverse reactions included hand-foot skin reaction (61％),diarrhea (46％),hypertension (21％).Most adverse reactions occurred around the second week after drug therapy,with the duration unequal.The majority of adverse reactions could be released by symptomatic treatment,which did not affect the medication.Conclusion Sorafenib has good short term efficacy for patients with advanced renal cell carcinoma,and most adverse reactions were tolerable.

Objective To observe the therapeutic effect of Jingganquzhi decoction(JQ,净肝祛脂汤) in treating non-alcoholic fatty liver.Methods Eighty patients with non-alcoholic fatty liver were randomly divided into treatment group to receive JQ and control group to receive Dongbaogantai(DG,东宝肝泰) orally for 3 months.The changes of liver function,blood lipids,B ultrasonic examination were observed.Results After the treatment,the liver function criteria: alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),?-glutamyltransferase(?-GGT) and blood lipids of triglycerides(TG),total cholesterol(TC) were lower than those before the treatment,while the high-density lipoprotein cholesterol(HDL-C) was higher than that before the treatment in both groups(all P

Hypertension is one of the high prevalence diseases in Xinjiang,which severely affect the body-mind heath of the people.In Northwest area,particularly in xinjiang,dryness syndrome is prevailed owing to environmental factor.Therefore,dryness syndrome of climacteric hypertension in xinjiang is more prevalent than that in other areas.Discussion on the effect of environmental factors on climacteric hypertension is a main aspect of Northwest dryness syndrome study.It may provide reliable and helpful basis of prevention and treatment of climacteric hypertension in xinjiang.

The medication characteristics of doctor ZHENG Chong-guang in Qing Dynasty was studied from prescription metrology range index,including properties,tastes,channel tropism and function index.It was found that his clinic prescription practice was different from other doctors in Jiangzhe province which originated from his territory character,the territory character of Xin'an school was disclosed,it was suggested that prescription metrology range index was an valuable impersonal index for doctor's territory character.

This paper introduces the international experiments of risk management in clinical trails, responsibility of sponsor, responsibility of investigator and responsibility of other participators and to help to improve our management level of clinical trails.