Objective To observe the value of adenosine deaminase(ADA)in differential diagnosis of hydrothorax.Methods In this study,93 subjects were collected in the second Xiangya hospital from Oct 2007 to Mar 2008.The patients were divided into three groups.which were the malignant hydrothorax group,the tuberculous hydrothorax group and the transudative hydrothorax group.We measured the adenosine deaminase(ADA)in pleural effusion of every patients with continuous monitored enzymatic method.Results The values of ADA in the three group were(14.24±12.90)U/L,(49.36±15.75)U/L and(10.12±7.87)U/L,respectively.There were significant differences for the values of adenosine deaminase(ADA)among the three groups,For instance,The value of adenosine deaminase(ADA)in the tuberculous hydrothorax group was greatly different with that of the transudative hydrothorax group(P＜0.01).Conclusion Detection of adenosine deaminase(ADA)has highly differential diagnosis value and can be as supplementary method to diagnose tuberculous hydrothorax.

Objective To investigate the infectious rates of 9 common pathogens and epidemiology in children with acute respira‐tory tract infections(ARI) in Maoming district .Methods The serum were collected from 6 241 children with acute respiratory in‐fection .IgM of 9 common pathogen including Mycoplasma pneumoniae (MP) ,Legionella pneumophila (LP) ,Coxiella burnetii (C .burnetii) ,Chlamydophila pneumoniae(CP) ,adenovirus(ADV) ,respiratory syncytial virus(RSV) ,type A and type B influenza virus(INFA and INFB) ,and parainfluenza virus(PIVS) ,were detected using immunofluorescence assay .Results Among 6 241 ca‐ses ,1 320 showed atypical pathogens infection ,and infection rate was 21% .The positive rate of MP was 15 .12% ,the highest infec‐tious pathogen;followed by the positive rate of INFB ,LP ,ADV and PIVS were 3 .03% ,1 .92% ,0 .54% and 0 .22% respectively . The pathogens with the lowest positive rate were RSV ,COX ,INFA and CP ,their infectious rates were 0 .14% ,0 .11% ,0 .048%and 0 .016% respectively .Conclusion The infection rate of atypical pathogen among children is high in this area ,which should be taken seriously .MP is the most common pathogen in children with ARI in Maoming district .The pathogen positive rate has rela‐tionship with season .

Objective To investigate the effects of autologous blood transfusion and acute normovolemic hemodilution inflamma‐tory response in patients with spinal surgery .Methods 60 patients with spinal surgery ,were randomly divided into the control group ,autologous blood transfusion group ,acute normovolemic hemodilution group ,20 cases in each group .The control group in in‐traoperative bleeding time and blood input variants of inventory .Autologous blood transfusion group was used in combination with intraoperative autologous blood recovery unit ,lose banked blood hemoglobin was low .Acute normovolemic hemodilution group via peripheral vein input must first crystal liquid or gel liquid ,then through internal jugular vein slowly pulled out the body′s blood into the special bags containing anticoagulant ,swing machine through blood kept shaking ,input when appropriate .Preoperative(T1) , After surgery 2 h(T2) ,6 h(T3) ,12 h(T4) and 24 h(T5) blood at each time point 5 mL ,detect the WBC ,IL‐6 ,TNF‐α.Records with and without postoperative complications .Results WBC in autologous blood transfusion group and acute normovolemic he‐modilution group were higher than that of preoperative ,difference was statistically significant(P<0 .05);In T2 -T5 ,serum IL‐6 , TNF‐a and the WBC concentration compared with the basis of their respective value(T1) increased significantly ,but were signifi‐cantly lower than control group ,the difference was statistically significant(P< 0 .05) .Postoperative follow‐up of the autologous blood transfusion group and acute normovolemic hemodilution group and no complications .Conclusion The autologous blood trans‐fusion group and acute normovolemic hemodilution group could effectively reduce the intraoperative and postoperative systemic in‐flammatory response ,which obviously save blood resources .

Objective Discuss the interference of injection cefotiam on vanadate oxidation method and dry chemical method assay total bilirubin .Methods Collected 60 examples ,include total bilirubin concentration 20 examples less than 20 μmol/L ,20 examples between 150-220 μmol/L and 20 examples between 350-410 μmol/L ,add an equal volume of various concentrations of cefotiam in each case ,formulated into cefotiam final concentrations of 300 ,150 ,75 mg/L of serum samples as the test group ,add an equal volume of water in each serum samples as the control group ,determine all the samples total bilirubin concentration respectively by vanadate oxidation method and dry chemical method ,compared the interference of cefotiam on determined total bilirubin by two method ,analyze the data by SPSS13 .0 .Results Determined total bilirubin by dry chemical method ,the test group higher than the control group ,the difference was statistically significant(P<0 .05) ,at the same total bilirubin levels ,with cefotiam concentrations decreased ,increased rate of total bilirubin concentration were decreased in the experimental group .Determined total bilirubin by vanadate oxidation method ,when the total bilirubin concentration between 150 -220 μmol/L ,the test group was higher than the control group ,the difference was statistically significant(P<0 .05) .Conclusion Interference of injection cefotiam on determined to‐tal bilirubin by dry chemical method is strong ,and with the drug concentration increased ,effect is more obvious ,but determination of total bilirubin by vanadate oxidation method has almost no effect .

Objective To investigate the changes of urine microalbuminuria(UMA) and serum C‐reactive protein(CRP) levels in patients with diabetic retinopathy(DR) and its significance .Methods A total of 152 type 2 diabetes mellitus(T2DM ) patients were included and 40 healthy individuals as normal controls(NC) .T2DM patients were divided into 3 groups ,65 patients with non‐dia‐betic retinopathy(NDR group) ,53 patients with non‐proliferative diabetic retinopathy(NPDR group) and 34 patients with prolifera‐tive diabetic retinopathy(PDR group) .UMA ,CRP and other clinical parameters were detect .Results The level of UMA and CRP increased progressively from NC ,NDR ,NPDR ,to PDR groups ,and there were significant differences among groups(P<0 .05) .The analysis of spearman rank correlation showed that UMA was positively associated with CRP(r=0 .311 ,P<0 .05) .UMA was also positively associated with the duration of diabetes ,fasting blood glucose(FBG) ,low density lipoprotein cholesterol(LDL‐C) ,hemo‐globin A1c(HbA1c) and homeostasis model assessment of insulin resistance(P< 0 .05) ,and CRP was also positively associated with the duration of diabetes ,FBG ,HbA1c and HOMA‐IR(P<0 .05) .Conclusion The development of DR is closely associated with kidney injury ,and chronic inflammation ,hyperglycemia and insulin resistance may be involved in the development and patho‐genesis of DR by interacting the renal function of T2DM patients .

Objective To investigate the HCV patients with HCV‐RNA and AFP different plastid percentage (AFP‐L3/AFP) correlation ,analysis of liver cirrhosis to liver cancer caused by hepatitis c in the process of the development of HCV‐RNA and AFP‐L3/AFP change characteristics .Methods Collected clinical confirmed simple HCV patients 80 cases ,including 44 patients with cir‐rhosis of the liver and 36 cases of HCV liver cancer group and liver cirrhosis group were followed up at 3 ,6 months ,follow‐up re‐sults are divided into transfer of liver cancer group and treatment group ,in addition to choose 60 cases of healthy people as control group .Using case‐control study .Between different groups of HCV‐RNA and AFP‐L3/AFP compared by t test .Results The liver cirrhosis group average HCV‐RNA ,AFP‐L3/AFP for 7 .15 × 103 copy/mL ,44 .3% ,compared with the control group 400 copy/mL ,1 .1% ,the difference was statistically significant(P< 0 .05) .Liver cirrhosis group average HCV‐RNA ,AFP‐L3/AFP for 8 .33 × 109 copy/mL ,3 .35% ,and HCV liver cancer group (5 .71 × 107 copy/mL ,94 .33% ) ,the difference was statistically signifi‐cant(P<0 .05) .3 months follow‐up of patients with liver cirrhosis have 4 cases for the development of liver cancer ,8 cases after 6 months for the development of liver cancer .Conclusion The patients with cirrhosis caused by hepatitis c virus (HCV) should be combined ,dynamic detection of HCV RNA and AFP‐L3/AFP ,in order to early discover the liver cancer .

Objective To analyze the voluntary blood donors of Shaoguan city in recent 10 years HIV infection status and distri‐bution characteristics ,and to take effective prevention and control measures ,in order to reduce the risk of HIV infection through blood transfusion .Methods HIV screening test in the early by the reagent of two different manufacturers ,from 2005 to 2014 vol‐untary blood donors specimens of 265 771 doses of blood donation in Shaoguan ,and early screening positive specimens confirmed by Center for Disease Control of Shaoguan .Results The voluntary blood donors of Shaoguan in the 10 years that initial screening test anti‐HIV positive were 310 cases ,and 35 cases confirmed positive;The confirmed positive rate was 1 .317/10 000;The HIV infec‐tion rate in 2012 was highest (2 .867/10 000) and there were 9 cases ,which was significant difference (P<0 .05) .The district of the maximum rate was New Fengxian ,which was 5 .369/10 000 ,and different districts had significant difference (P<0 .05) .The epidemiology survey about HIV infections found that male were 30 cases(85 .71% ) ,which was significantly more than women;By age distribution ,most HIV infections were 18 to 35 years old young adults ,which accounted 26 cases(74 .29% ) .Married and un‐married people infected respectively accounted 28 .57% and 71 .43% .The occupations of HIV infections were scattered with farm‐ers ,staffers ,the service industry ,cadres in the majority .The HIV infection rate with low education was relative higher ,which had some relationship to educational level .The residents and the non‐residents infected respectively accouted 71 .43% and 28 .57% ;Blood donors for the first time of HIV infections were 24 cases (68 .57% ) .Blood donors for the second time of HIV infections were 11 cases (31 .43% );Other virus co‐infection respectively were 2 HBV infections ,1 HCV infection and 3 syphilis infections .The route of transmission was mainly through sexual transmission that was mainly heterosexual transmission ,which was 33 cases (94 .58% ) .Conclusion The voluntary blood donors of Shaoguan with HIV is on the rise ,and give priority to with male youths spread through heterosexual sex .It should be pay high attention to by the government ,society and blood stations ,and strengthen the propaganda work of AIDS prevention and control checks ,and minimize the risk of HIV transmission by blood transfusion in or‐der to guarantee the safety of clinical blood transfusion .

Objective To evaluate the effects of exposure to MALs on immunity against Mycobacterium tuberculosis in human alveolar macrophages .Methods Plate counting were used to evaluate the effect of resisting Mycobacterium tuberculosis in human alveolar macrophages .Culture supernatants were harvested and human TNF‐α was measured by ELISA kit .Total nitrite levels in the media were measured using the Griess reagent .Results MALs stimulation attenuated the control of intracellular mycobacterial growth in human alveolar macrophages .The production of proinflammatory cytokines TNF‐α and Nitric oxide in human alveolar macrophages induced by Mycobacterium tuberculosis purified protein derivatives tuberculin (Mt‐PPD) and human interferonγwere attenuated by pretreatment in vitro with MALs .Conclusion MALs attenuated the responses of human alveolar macrophages a‐gainst Mycobacterium tuberculosis ,which may provide the new evidence to explain the phenomena in which some component of Mycobacteria in environment impacts the immunity against Mycobacterium tuberculosis infection .

Objective To study status and risk factors of nosocomial infection of Pseudomonas aeruginosa in hospital ,provided a basis to clinical control infected of PDRPA .Methods Monitoring of nosocomial infection of Pseudomonas aeruginosa from Februar‐y 2014 to March 2012 in our hospital ,retrospective analysis of the clinical data of the corresponding cases ,analysis of the risk fac‐tors for PDRPA infection .Results PDRPA was mainly distributed in the severe medicine department and department of Neurosur‐gery ,given priority to with sputum ,59 .5% and 31 .0% were the source of the pan resistant strains ,respectively ;Age ,duration of hospitalization ,use of antimicrobial drugs ,the use of carbapenems ,the use of cephalosporins ,quinolones ,diabetes ,coronary heart disease ,deep vein intubation ,endotracheal intubation ,ventilator ,nasogastric tube and PDRPA infection significantly correlated(P<0 .05) ,There was no significant correlation with tumor ,the use of amino glycosides and mixed infection(P>0 .05) .Conclusion Age ,duration of hospitalization ,use of antibacterial drugs ,the use of carbapenems ,the use of cephalosporins ,quinolones ,diabetes , coronary heart disease ,deep vein intubation ,endotracheal intubation ,ventilator ,nasogastric tube is a risk factor for PDRPA infec‐tion ,Control of diabetes ,coronary heart disease ,rational use of antimicrobial agents ,reduce the invasive operation is the key to pre‐vent and control nosocomial infection in PDRPA .

Objective To analysis the changes of serum adiponectin level in patients with breast cancer and its clinical signifi‐cance .Methods 35 cases of serum adiponectin levels in breast cancer patients using enzyme‐linked immunosorbent assay ,and 35 healthy serum adiponectin level in peripheral blood of women ,analysis of significance of changes of serum adiponectin levels in breast cancer patients .Results Average serum adiponectin level in patients with breast cancer group(6 .13 ± 1 .55)μg/mL ,health group average serum adiponectin levels (8 .72 ± 1 .86)μg/mL ,the difference was statistically significant(P<0 .05) .Postmenopausal women in breast cancer group and health group compared with premenopausal women ,the serum adiponectin levels were signifi‐cantly increased ,there was a statistically significant difference(P<0 .05) .Lymph node metastasis of breast cancer serum adiponec‐tin levels were significantly lower in patients without lymph node metastasis in patients with breast cancer ,the difference was statis‐tically significant(P<0 .05) .Serum adiponectin level in breast cancer patients with stage Ⅱ and Ⅲ were significantly lower than breast cancer patients with stage Ⅰ ,there was a statistically significant difference(P<0 .05) .Conclusion Serum adiponectin levels as an important marker in the diagnosis of breast cancer ,serum adiponectin level and grade of the tumor ,lymph node metastases . Significantly reduced serum adiponectin level in patients with breast cancer ,and not under the influence of patients with menopause .