Seizures may be the first or sometimes the only manifestation of patients with glioma in clinics. The aim of operation is to eliminate epilepsy far beyond mere resection of tumor mass. The underlyling mechanisms of glioma-associated epileptogenesis are poorly understood. Recently the theory of amino-acid like neurotransmitters in chemical synapse is gradually accepted. However, the molecular mechanisms remain to be further investigated on how glutamate release is regulated and how synaptic homeostasis in peripheral neurons is kept or disturbed. So detailed studies are needed to clarify specific molecular target and provide proper evidence for optimal antiepileptic drugs in glioma-associated epileptoge-nesis.

Objective To study the imaging findings, clinical and pathological characteristics of langerhans cell histiocytosis(LCH)in limbs of children, and to improve the imaging diagnostic accuracy of LCH . Methods Imaging findings and clinical data of 12 patients with limbs LCH were analyzed retrospectively. X-ray examination was performed in 10 cases, while 9 cases underwent CT and 7 cases underwent MRI examination. All imaging findings were analyzed. Results Seven lesions were solitary, including 4 lesions in the tibia, 2 in the radius and 1in the ulna. Five cases had limbs lesion in multiple sites, which included 12 bone lesions in total, with 6 lesions in the femur, 3 in the humerus (1 case involved the epiphysis), 2 in the tibia and 1in the radius. The X-ray or CT images of the lesions showed osteolytic destruction and swelling of the bone, which was commonly associated with the reaction of periosteum. Eleven cases were with peripheral soft tissue swelling, and one case had soft tissue mass. The lesions showed low signal on T1WI and high signal or mixed signal on T2WI. Six cases were diagnosed as LCH at the first time and the other 6 cases were diagnosed as infectious lesions. Twelve cases were regularly followed up after the treatment, and the prognosis of the patients with single lesion was better. Conclusions LCH of limbs usually involves diaphyseal and metaphyseal bone. The imaging features include osteolytic destruction and swelling of the bone, with peripheral soft tissue swelling or mass of the soft tissue. Although LCH of limbs has some specific imaging features, it is difficult to differentiate it from malignant bone tumors. Multi-imaging modalities such as radiography, CT and MRI imaging may suggest the diagnosis and provide important information for evaluating prognosis.

Objective To analyze the correlation between the positive rate of autoantibody and hepatitis C virus load and the relationship between the positive incidence and the status of liver function in patients infected HCV.Methods 168 patients infected hepatitis C virus were included,to detect serum autoantibody,HCV loads and liver function file.And 129 healthy controls were collected to test the serum autoantibody.Using the Chi-square test to analyze the count data,and performing student test or Nonparametric test to study measurement data,compared the positive rate of autoantibody in patients with HCV and that in healthy controls.Analyzed the correlation among the positive incidence of autoantibody,HCV load and the status of liver function in patients infected HCV,and studied the relationship of the positive rate of autoantibody with age and also with gender of the patients.Results The positive rate of autoantibody in patients with HCV was 35.12%(59/168),in which ANA accounted for 33.93%,SMA took up 2.98%,AMA-M2 made up 1.80% and anti-LKM1 1.20%.No patient existed LC-1 or SLA/LP in his/her serum.The total positive rate of autoantibody and ANA both were higher in pa-tients than in healthy controls (χ2=23.179,P=0.000;χ2=21.360,P=0.000).There existed no significant difference in the levels of HCV load,total bilirubin (TBil),ALT and AST between the patients whose autoantibody examinations were positive and those who were negative in autoantibody test (χ2=0.113,P=0.945;Z=-1.087,P=0.277;Z=-1.356,P=0.175;Z=-0.153,P=0.878).The positive rate of autoantibody not correlated with the gender (χ2=2.897,P=0.089), but related to the age (t=3.274,P=0.001)of the patients.There existed significant difference in the levels of ALT,AST and the age between the patients HCV RNA negative and those HCV RNA positive (Z=-6.430,P=0.000;Z=-6.123, P=0.000;t=-3.152,P=0.002),and the patients whose HCV RNA were negative younger than those who with HCV RNA positive (44.17 vs 55.27 years).Conclusion It is easy for autoimmunity to occur on persons infected HCV.The posi-tive rate of autoantibody is related to patients’age,but not to the HCV amount in patients.Besides,it cannot predict the sta-tus of the patients’liver injury that weather the autoimmunity appears.But HCV load correlated with patients'age and liver inj ury,which older group patients bring higher virus load and had more serious liver damage.

ObjectiveTo assess the effect of hemodialysis(HD),hemodiafiltration(HDF) and hemodialysis(HD) and hemoperfusion(HDP) on the quality of life,cognitive function and nutritional status in chronic renal failure(CRF) patients.MethodsAll patients were randomly divided into HD,HDF and HDP group.Mini-mental state examination(MMSE),Wisconsin card sorting test (WCST),SF-36 were measured for cognitive function,quality of life and nutrition indicators test.ResultsAfter 3,6 months treatment,MMSE ( respectively ( 22.62 ±3.85),(25.10 ±2.26),(25.35 ±2.44)and (23.87 ±4.19),(25.10 ±2.26),(27.19 ±2.23)),WCST indicators were statistically significant in the three groups (P ＜ 0.05 ) ;after 1,3,6 months treatment,the PF,RP,BP,GH,SF and nutrition indicators were significant difference too(P＜0.05 ) ; HDP and HDF,HD groups were statistically significant(P＜ 0.05 ).ConclusionHDF and HDP obviously influence on long-term cognitive function,physical health domains and nutritional status in CRF patients,and superior to HD.

Objective To survey the resistance profile of clinical isolates to antibiotics across the hospitals in Dongguan,Guangdong Province during 2015.Methods Kirby-Bauer method or automated system was used to test the susceptibility of clinical isolates to selected antimicrobial agents.Results were analyzed according to CLSI 2015 breakpoints.The susceptibility data were analyzed using WHONET 5.6 software.Results A total of 29 665 strains of microorganisms were isolated,of which gram positive cocci accounted for 32.1％ (9 509/29 665) and gram negative bacilli accounted for 67.9％ (20 156/29 665),respectively.The prevalence of methicillinresistant Staphylococcus was 23.3％ (705/3 024) in S.aureus and 43.6％ (1 054/2 419) in coagulase-negative Staphylococcus.No vancomycin-resistant staphylococcal strain was found.ESBLs-producing strains accounted for 36.4％ (2 554/7 020) in E.coli and 24.5％(792/3 227) in Klebsiella isolates.The prevalence of carbapenem-resistant Enterobacteriaceae was 0.2％ (30/13 077).The prevalence of carbapenem-resistant Pseudomonas aeruginosa (CRPA) and carbapenem-resistant Acinetobacter baumannii (CRAB) was 16.0％ (500/3 116) and 53.9％ (827/1 533),respectively.The prevalence of penicillin-resistant S.pneumoniae (PRSP) strains was 10.1％ (142/1 404).Beta-lactamase was produced in 30.6％ (276/902) of the H.influenzae strains.The prevalence of vancomycin-resistant Enterococcus (VRE) strains was 0.7％ (10/1 441).Conclusions Periodic surveillance of antimicrobial resistance is valuable for rational antimicrobial therapy,formulation of treatment guidelines and infection control and prevention measures,as well as preventing the spread of drug-resistant strains.

Objective To explore the influence of acupuncture point massage combined with limb function exercise on ankle brachial index (ABI) and pulse wave velocity (PWV) in patients with coronary heart disease (CHD). Methods According to scores by grace score scale, 180 CHD patients were divided into three groups: low risk group (n=58), moderate risk group (n=68) and high risk group (n=54). Within the three groups, the patients were divided into the experiment group and the control group by using the random digital table. The control group was treated with routine nursing intervention , while the experiment groups accepted acupuncture point massage and limb function exercise training on the basis of control groups. We collected the values of ABI and PWV at four points-in-time: before intervention, 7 days after intervention, 30 days after intervention and 90 days after intervention. Results Repeated measurement data analysis of the experiment group and control group suggested that:in the moderate and high risk groups, there was statistically significant difference (P<0.05) in the data at the four time points. There was no statistically significant difference (P > 0.05) in time and group interaction effect. The difference between the experiment group and control group was statistically significant (P<0.05). Repeated measurement data analysis showed that there was no statistically significant difference (P>0.05) in ABI&PWV interaction effect at the four time points between the experiment group and control group. In the low-risk group,the differences in time points compared with the main effect were insignificant (all P>0.05). In comparison of main effect at all the four time points, there was significant different in the moderate and high risk group (P<0.05), And it suggested that time and group interaction, namely effect of time factor (1 d, 7 d, 30 d, 90 d), was not decided by the division of groups. In comparison of main effect, the difference was statistically significant (all P < 0.01) in the moderate and high-risk group, which indicated the main effect (intervention) playing main role. However, there was no statistically significant difference (P>0.05) of ABI&PWV before and 90-days after intervention. Conclusion Acupuncture point massage combined with limb function exercise can effectively improve the peripheral artery blood supply in CHD patients, lower ABI and promote PWV.

Objective To observe the clinical efficacy of HE’s needling method (three ways for unblocking) in treating mild simple obesity due to dampness from spleen deficiency.Method Forty eligible subjects with mild simple obesity due to dampness from spleen deficiency were randomized into group A and group B, 20 cases in each group. Group A was intervened by mild unblocking method plus intensive unblocking method from HE’s needling method, and group B was by mild unblocking method plus warm unblocking method. The obesity-related indexes were observed before and after treatment, and the clinical efficacies were compared.Result The body weight and Body Mass Index (BMI) were significantly changed after intervention in the treatment group (P<0.05). The body weight was significantly changed after treatment in the control group (P<0.05). After treatment, there were no significant differences in comparing the obesity-related indexes (body weight, BMI, waist circumference, hip circumference, and waist-hip ratio) between the two groups (P>0.05). The total effective rate was 55.0% in the treatment group versus 10.0% in the control group, and the difference was statistically significant (P<0.01).Conclusion HE’s needling method is effective in treating mild simple obesity due to dampness from spleen deficiency, and mild unblocking method plus intensive unblocking method can produce a more significant efficacy compared to mild unblocking method plus warm unblocking method.

Objective:To study risk factors and clinical outcomes of nosocomial infection (NI) in extremely premature infants (EPIs).Methods:From January 2017 to December 2021, EPIs admitted to NICU of our hospital were retrospectively studied. The infants were assigned into NI group and non-NI group. The NI group were further assigned into survival group and death group. Single factor analysis was conducted using chi-square test, t-test and non-parametric test. Multiple logistic regression was used to analyze risk factors of NI and death.Results:A total of 115 cases were enrolled, including 67 (58.3%) in NI group, 54 in survival group and 12 in death group. One case gave up treatment. 48 cases were in non-NI group. 81 episodes of nosocomial infections occurred in NI group and the case infection rate was 70.4% (81/115). 48 cases (41.7%) had late-onset sepsis, 14 (12.2%) neonatal necrotizing enterocolitis, 13 (11.3%) pneumonia, 1 (0.9%) urinary tract infection and 1 (0.9%) thrush. Hemodynamic significant patent ductus arteriosus (hsPDA) and long duration of parenteral nutrition were independent risk factors for NI in EPIs ( P<0.05). The incidence of bronchopulmonary dysplasia (BPD) (100.0% vs. 70.8%) and mortality (17.9% vs. 2.1%) in NI group was higher than non-NI group ( P<0.05). Septic shock was an independent risk factor for the death due to NI. Conclusions:The incidence of NI in EPIs is high. hsPDA and long duration of parenteral nutrition are independent risk factors for NI in EPIs. EPIs with NI have high incidence of BPD and mortality and septic shock is an independent risk factor for death.

Objective To investigate the antimicrobial resistance profile of clinical isolates in Dongguan Tungwah Hospital during 2016.Methods Antimicrobial susceptibility testing was carded out for the clinical isolates collected from Dongguan Tungwah Hospital according to a unified protocol using Kirby-Bauer method or automated systems.Result were analyzed according to CLSI 2016 breakpoints.Results Of the 3 482 clinical isolates,gram positive cocci and gram negative bacilli accounted for 34.4％ (1 199/3 482) and 65.6％ (2 283/3 482),respectively.The prevalence of methicillin-resistant strains was in 28.7％ (86/300) in S.aureus and 77.7％ (300/386) in coagulase-negative Staphylococcus isolates.No staphylococcal strains were found resistant to vancomycin or linezolid.Overall,one E.faecium strain was identified as resistant to vancomycin by instrument method and confirmed by vancomycin E test.The prevalence of ESBLs-producing strains was 59.6％ (337/565) in E.coli and 29.8％ (115/386) in Klebsiella spp.(K.pneumoniae and K.oxytoca).Enterobacteriaceae strains were still highly susceptible to carbapenems.Overall,0.4％ and 0.2％ of the Enterobacteriaceae strains were resistant to imipenem and meropenem,respectively.About 38.3％ and 36.9％ of Acinetobacter strains were resistant to imipenem and meropenem,respectively.Conclusions Surveillance of antimicrobial resistance is most important and valuable for understanding the changing resistant pattern in local hospital and rational selection of antimicrobial agents.More attention should be paid to surveillance of antimicrobial resistance to avoid the spread of drug resistant strains.

This paper introduced the legislative development of community benefits system of nonprofit hospitals at federal level in the United States,as well as state legislatures in this regard. Based on America's experiences, an analysis was made on the "community benefits and health promotion model", which refers to community health needs assessment, health promotion programs, program implementation, supervision and appraisal. Thus the authors put forward inspirations for the social responsibility system development of public hospitals in China as follows. This refers to the establishment of hospitals' social responsibility system; development of community health promotion planning based on health needs;and establishment of social responsibility information disclosure system for fulfillment of their social responsibilities.