Objective To explore the clinical value of tuberculous infection of T cells spot test (T-SPOT. TB)for diagnosing tuberculous pleurisy in immunocompromised patients. Methods The sensitivities of T-SPOT. TB,ADA, TB-DNA and tuberculosis antibodies to tuberculous pleurisy in 54 immunocompromised patients were compared.Among these patients,22 were retested by T-SPOT. TB after 2 months anti-tuberculosis treatment. Spot forming cells(SFCs) were compared before and after treatment. Results The diagnostic sensitivity of T-SPOT.TB (79.63%)was significantly higher than those of ADA (64.81%),TB-DNA (48.15%)and tuberculosis antibodies (55.56%) (P<0.05).22 patients were retested by the T-SPOT.TB after anti-TB treatment (2 months), the results showed that the positive rate of T-SPOT.TB was 90.91%,not significantly than previous tests (P<0.05).Both ESAT-6 and CFP-10 specific SFCs decreased significantly compared with those before anti-TB treatment (t=2.728 and 2.400,P<0.05 respectively). Conclusions T-SPOT.TB assay has satisfactory sensitivity and could be used in diagnosis of tuberculous pleurisy in immunocompromised patients.

Objective To investigate the significance of serum cortisol and high‐sensitivity C‐reactive protein (hs‐CRP) test in elderly patients with neurasthenia .Methods A total of 160 elderly patients with neurasthenia in our hospital from January 2012 to June 2015 were selected as the research subjects (observation group) and 160 individuals undergoing the physical examination as the control group .The differences of serum BDNF ,CORT and hs‐CRP levels were compared between the two groups .The patients were divided into the obvious anxiety group and anxiety group according to the Hamilton Anxiety Scale (HAMD) .The differences of serum BDNF ,CORT and hs‐CRP levels were compared between these two groups ;meanwhile serum BDNF ,CORT and hs‐CRP levels after treatment in the patients with ideal curative effect were detected and the detection results were statistically compared with those before treatment .Results The BDNF and CORT levels in the observation group were significantly lower than those in the control group ,while the hs‐CRP level was significantly higher than that in the control group ;the BDNF and CORT levels in the obvious anxiety group were significantly lower than those in the anxiety group ,while the hs‐CRP level was significantly higher than that in the anxiety group ;the treatment outcome also showed that the BDNF and CORT levels after treatment in the patients obtai‐ning the ideal effect were significantly increased compared with the pre‐treatment levels ;while the hs‐CRP level was significantly decreased .Conclusion BDNF ,CORT and hs‐CRP are significantly correlated with neurasthenia occurrence and its severity ,which deserves to pay attention to in clinical practice .

Humans ; Infant, Newborn ; Lung Diseases ; Pulmonary Artery ; Thrombosis

Objective To observe the occurrence of vascular calcification in maintenance hemedialysis (MHD) patients. Method Sixty-nine MHD patients were enrolled in this study. Vascular calcification was evaluated by plain X-my films of chest, upper and lower extremites. Analyzed the relationship of vascular calcification and cardiovascular disease. Results Vascular calcification on X-ray films presented in 38 cases (55%). Of the 23 cases with calcification on arteries of extremites, 14 cases were found to have both intimal calcification and medial calcification. Patients with vascular calcification were older. Ischemic heart disease and cardiac failure appeared more frequently in the patients with vascular calcification. Conclusions Both intimal calcification and medial calcification are frequently found in the MHD patients. Vascular calcification is probablly associated with cardiovascular disease in MHD patients.

Objective To observe the protection of Caspase inhibitor(zVAD-fmk,benzyloxycarbonyl-Val-Ala-Asp-fluoromethyl ketone) on neonatal rat with hypoxic-ischemic brain damage(HIBD).Methods Thirty-six neonatal rats,7 days old,were randomly divided into hypoxic-ischemic(HI) control group(A),zVAD-fmk treated group(B) and sham group(C).Before HI insult,a pan-Caspase inhibitor,zVAD-fmk or normal buffer solution was injected into the cerebral ventricle.The water content of cerebral hemisphere was measured and the percentage of apoptofic cells in hippocampal neurons was measured by Flow cytometer(Annexin V/PI) at 24 hours after HI insult.The effect on body weights(percentage of increased weight,WIP) and macroscopical changes(percentage of cortox and hippocampal dead neurons) were assessed at 14 days.Results Compared with group A,the water content of ischemic hemisphere and apoptosis percentage of hippocampal neurons in group B reduced significantly.The difference of percentage of increased weight at 14 days in group B was not significantly.Microscopic examination showed that cortox and hippocampus neural death rate in group B was proved significantly reduced compared with that in group A.Conclusion Intracerebral administration of zVAD-fmk has protective effects on hypoxic-ischemic brain damage in neonatal rat.

Objective To explore the use of enzyme-linked immunosorbent assay(ELISA) to test the serological BP180NC16A-ELISA index in patients with bullous pemphigoid (BP) and investigate the relationship of this index with disease monitoring and therapeutic guidance.Methods The serological BP180NC16a-ELISA index at different times was examined in twenty BP patients with ELISA kit and monitor changes of pre-treatment BP180NC16a-ELISA index condition score and efficacy relationship..Results Twenty patients tested by ELISA had 19 cases of positive patients with positive rate of 95.0％ and one case negative with negative rate of 5.0％.After treatment,19 cases (19.60 ±4.63)d became stable,and condition score was (3.75 ± 1.37) points.After continued treatment (28.75 ± 6.11) d entering clinical remission,condition score was (2.25 ± 1.21)points.Compared with the score before treatment condition [(5.55 ± 1.61) points],differences were statistically significant (Z =-3.808,-3.965,P ＜ 0.01),and clinical remission score below clinically stable condition (Z =-3.808,P ＜0.01).A total of 19 cases of patients' pre-ELISA treatment index were positive correlation with after treatment stable period and clinical remission period (rs =0.788,0.752,P ＜ 0.01).Conclusions This study demonstrated that ELISA-detected BP180NCI6a-ELISA index was positively correlated with the BP disease severity and clinical course,which could be as the guideline to monitor and clinical treatment.

Objective To investigate the clinical efficiency of Isophane Protamine Biosynthetic Human Insulin Injection (pre‐mixed 30R)(Novolin 30R) combined with insulin pump therapy in patients with diabetes mellitus complicated with pulmonary in‐fection ,and to analyze the detection indexes .Methods From Jan .2010 to Feb .2013 ,90 cases of patients with diabetes mellitus com‐plicated with pulmonary infection were selected and divided into the observation group and control group .The control group re‐ceived Novolin 30R treatment and conventional treatment ,the observation group were given insulin pump therapy based on the treatment of control group .The clinical efficiency and detection indexes were compared and analyzed .Results The cure rate and to‐tal effective rate were 51 .11% and 82 .22% respectively in the control group ,and were 84 .44% and 100 .00% in the observation group respectively .There were significant differences of both cure rate and total effective rate between the two groups (P<0 .05) . There were statistically significant differences of hospitalization time ,the time for reaching target of glucose ,insulin dose ,recovery time of body temperature ,hospital costs ,incidence rate of complications ,serum levels of sodium ,potassium and urea nitrogen ,os‐molality and PH value between the two groups(P<0 .05) .Conclusion The combination of Novolin 30R and insulin pump therapy could provide satisfactory clinical efficiency in patients with diabetes mellitus complicated with pulmonary infection .

Objective To investigate the clinicopathological features and risk factors of lymph node metastasis of gastrointestinal neuroendocrine neoplasms (GI-NENs).Methods The retrospective case-control study was conducted.The clinicopathological data of 467 patients with GI-NENs who were admitted to the Fourth Hospital of Hebei Medical University from January 2006 to December 2015 were collected.Observation indicators:(1) occurrence sites and pathological classification of GI-NENs;(2) pathological characteristics of surgical specimens of GI-NENs;(3) univariate analysis and multivariate analysis affecting lymph node metastasis of GI-NENs:sex,age,tumor location,tumor diameter,pathological classification,pathological stage and tumor invasive depth.The univariate analysis and multivariate analysis were respectively done using the chi-square test and Logistic regression model.Results (1) Occurrence sites and pathological classification of GI-NENs:of 467 patients with GI-NENs,tumors of 304,15,7,14 and 127 patients were located at stomach,duodenum,small intestine,colon and rectum,respectively.Tumor diameter was 0.3-12.0 cm,with an average diameter of 2.2 cm.Of 467 patients with GI-NENs,G1 and G2 of neuroendocrine tumors (NETs),G3 of neumendocfine carcinomas (NECs) and mixed adenoneuroendocfine carcinomas (MANECs) were respectively detected in 209,64,146 and 48 patients.Lymph node metastasis rate of GI-NENs was 31.48％ (147/467).(2) Pathological characteristics of surgical specimens of GI-NENs:NETs were high-differentiated NENs.Ceils of NETs were solid and nest-,trabeculum-and tubular-shaped,and consisted of small or medium cells,with moderate amount or massive cytoplasms,round or oval nucleus,particle-shaped chromatin,unobvious nucleolus and positive endocrine markers.There were abundant of small blood vessels and surrounding fibrous stroma in peripheral tumor cell nests.NECs were low-differentiated NENs and included small cell carcinoma and large cell NEC.Cells of small cell carcinoma were small round or oval and looked similar to lymphocytes,with few amount cytoplasms,fine granularshaped or hyperchromatic nucleus and common mitosis figures.Cells of large cell NEC were large and greater than 3 lymphocytes,arrayed in organoid-or chrysanthemum-shape,with massive cytoplasms,coarse particle-shaped chromatin,obvious nucleus,clear mitosis figures and large laminar-shaped necrosis.There were different positive expressions of endocrine markers between small cell carcinoma and large cell NEC.MANECs had the characteristics of glandular cavity formation of traditional adenocarcinoma and NENs.Results of immunohistochemical staining in 467 patients showed that Ki-67 of 467 patients was positive;CD56 in 379 of 428 with CD56 test was positive;synaptophysin (Syn) in 416 of 422 with Syn test was positive;cytokeratin (CK) in 354 of 396 with CK test was positive;chromogranin (CgA)in 264 of 388 with CgA test was positive;neuron specific enolase (NSE) in 287 of 346 with NSE test was positive.(3) Univariate analysis and multivariate analysis affecting lymph node metastasis of GI-NENs:results of univariate analysis showed that sex,tumor location,tumor diameter,pathological classification,pathological satge and tumor invasive depth were related factors affecting lymph node metastasis of patients with GI-NENs (X2 =20.654,18.182,26.788,184.709,163.738,195.391,P＜ 0.05).Results of multivariate analysis showed that pathological classification and pathological stage were independent influenced factors affecting lymph node metastasis of patients with GI-NENs (HR =2.129,7.171,95％ confidence interval:1.273-3.561,-2.327-22.098,P＜0.05).Conclusions GI-NENs are mostly located on the stomach and rectum.Results of immunohistochenical staining could help diagnosis of GI-NENs.Pathological classification and pathological stage are independent influenced factors affecting lymph node metastasis of patients with GI-NENs.

Objective To provide references for building the medical rehabilitation system in China by learning the progress and compliance of rehabilitation departments construction at tertiary hospitals. Methods Comparative and quantitative methods were used for dynamic analysis qualitative interview to learn the index compliance of the hospitals in question in 201 1-2012.Results Compared with 201 1, average days of stay of the rehabilitation departments declined in general,yet with insufficient therapists;introduction of early rehabilitation intervention was but 57.1%,and the functional assessment rate of rehabilitation service was less than satisfactory.Conclusion Lack of manpower,varying levels of medical rehabilitation services,and neglect for functional assessment were found to be the main problems in construction of medical rehabilitation departments for the time being.