Leptomeningeal metastasis (LM),with a high omission rate in diagnosis in approximately 5 ％～8 ％ of all patients, is increasingly recognized as a lethality complication. The diagnosis of LM remains challenges,but commonly can be established by CSF cytology or by definitive neuroimaging. Although a combination of focal radiotherapy,intrathecal chemotherapy,and systemic chemotherapy may be necessary to achieve optimal treatment of patients, but prognosis is unacceptable and therapy remains palliative in most patients.

Objective To analyze testing results and values of blood heterotypic lymphocyte in flu patients.Methods 100 cases of influenza patients and 100 healthy people were collected.The observation group for flu patients and control group of healthy people.Extraction of peripheral blood in patients with microscopic examination observing leukocyte,neutrophil,lymphocyte,intermediate cells,atypical lymphocytes under a microscope,and calculated the percentage in the patients in the two group cells to make analysis and comparison.Ratio in peripheral blood of patients and analysis of specific lymphocytes were also calculated between different ages.Results Peripheral blood lymphocytes in observation group was (11.1 ± 2.6) ％,which was significantly higher than than of the control group [(1.5 ± 0.5) ％].The difference was statistically significant (chi-square =16.9,P ＜ 0.05) ; White blood cells,the ratio of neutrophils,lymphocytes in observation group were obvious differenent compared with the control group(t/chi square are:13.2,11.3 and 12.6,P ＜ 0.05) ;Three ages of influenza patients peripheral blood lymphocytes of the opposite sex ratio has no difference(P ＞ 0.05).Conclusion Detection of peripheral blood lymphocyte heterosexual has great significance to the diagnosis of influenza with simple,convenient and feasible characters.It is worth to be used widely in clinical practice.

Objective: To evaluate the operational efficiency of the division-level hospitals of Xinjiang Production and Construction Corps. Methods: Use DEA’s CCR model and BCC model to calculate the overall efficiency, pure technical efficiency and scale efficiency of Xinjiang Production and Construction Corps, and use super-efficiency model to calculate efficiency ranking of the division-level hospitals. Results: In the total pattern, there were 28.6%of the agricultural division hospitals at the stage of constant returns scale;in the medical service model, there were only 14.3% hospitals at that stage. Conclusion: From the results of two models, the technical efficiency has more room for improvement, compared with efficiency scale. The hospital needs to improve the level of health care technique, avoid blind expansion, minimize unnecessary input, strengthen internal meticulous management, and improve the overall operating efficiency of the hospital.

Objective To survey the current clinical practice of chronic non-cancer pain (CNCP)management including opioid use in Chinese subgroup report of Current Practices of Cancer and Chronic Non-Cancer Pain Management:A Pan-Asian Study (ACHEON).Methods This questionnaire-based survey included 100 pain physicians and 250 patients experiencing CNCP in the period of September to December in 2013.Results CNCP management training was believed by 40％ of physicians,while 30％ reported adequate pain-relief training on opioid use.Opioids were not considered as the best choice for CNCP management by 65％ of physicians.The majority of location of pain with CNCP was legs/feet (59.2％) and neck (39.2％),arthritis (37.22％),overuse (26.91％),and poor posture (35.56％) were reported as the primary causes of pain.A portion (81.6％) of patients was under treatment,while 66.67％ of patients claimed to be satisfied with their current pain treatment.74.51％ of patients reported that CNCP management was effective pain-relief.Conclusions The Chinese physicians were insufficient cognition of CNCP management on opioid use.The CNCP education and cognition strengthening,CNCP management practice and patient's satisfaction are still necessary for Chinese physicians and patients.

OBJECTIVE:To observe clinical efficacy and safety of escitalopram combined with ozagrel sodium for elderly pa-tients with acute cerebral infarction complicated with anxiety and depression. METHODS:140 elderly patients with acute cerebral infarction complicating with anxiety and depression were divided into control group and observation group according to random number table method,with 70 cases in each group. Control group received routine treatment and Sodium ozagrel for injection 40-80 mg added into 0.9% Sodium chloride injection 500 ml,ivgtt,bid. Observation group was additionally given Escitalopram tablet 10 mg,qd. Both groups received treatment for 8 weeks. HAMA,HAMD,NIHSS and BI were compared between 2 groups before and after treatment,and clinical efficacy and the occurrence of ADR were observed. RESULTS:There was no statistical sig-nificance in HAMA,HAMD,NIHSS,BI before treatment and NIHSS,BI 1 week of after treatment between 2 groups(P>0.05). HAMA and HAMD of observation group 1,4,8 weeks after treatment,and NIHSS and BI of it 4,8 weeks after treatment were improved significantly;above indexes of control group were improved significantly 4,8 weeks after treatment,and the observation group was better than the control group,with statistical significance (P<0.05). The total effective rate of observation group was 87.14%,which was significantly higher than 74.29% of control group,with statistical significance(P<0.05). There was no statis-tical significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:Escitalopram combined with ozagrel so-dium is significantly effective for elderly patients with acute cerebral infarction complicated with anxiety and depression,and can significantly improve anxiety,depression and neurological function with good safety.

AIM:To determine the effect of reactive oxygen species on the baroreflex and to investigate the intracellular mechanism responsible for baroreflex dysfunction in the heart failure state.METHODS:In the rat model of cardiomyocytes infarct induced heart failure,baroreflex function was evaluated by measuring the relationship between renal sympathetic nerve activity(RSNA)responses and change of blood pressure by intravenous injection of nitroglycerin and phenylephrine.Alteration in baroreflex function was measured under the different reactive oxygen species(ROS)level induced by intracerebroventricular administration of several chemicals.RESULTS:(1)The range of RSNA response,average slope and maximum gain of baroreflex function curve were(92.2?9.9) mmHg,(0.07%?0.01%)/mmHg and(1.20%?0.10%)/mmHg,respectively,in CHF rats,which were significantly lower than those in sham rats(65.6?7.4) mmHg,(0.13%?0.02%)/mmHg and(3.00%? 0.20%)/mmHg(P

OBJECTIVE:To establish a simple method of the magnesium measurement i n the sodium-magnesium fructose-1,6-diphosphate METHODS:Ion exchange-EDTA titration was adopted RESULTS:The RSDs of both the precision and accuracy wer e less than 0 51% by the method(n=6) CONCLUSION:This method is convenient ,and the results are accurate It can satisfy the determination of sodium-magn esium fructose-1,6-diphosphates

Building civilized environment is not only the inevitable hequirement of obeying the law of natrue and society and stick to scientific development orientation, but also the inevitable choice to give a impetus to the career of public health and national health care and finally realize the goal of a harmonious society.

Objective To study the effect of nasal decontamination on clinical index of elderly patients with long -term indwelling nasogastric tube.Methods 89 elderly patients with long -term indwelling nasogastric tube were randomly divided into nasal decontamination group and routine treatment group.The sputum culture positive rate of bacterial and the incidence of pulmonary complications,pharyngitis,sinusitis of the two groups were observed. Results Sputum Staphylococcus aureus positive rates in the nasal decontamination group and conventional group were 13.043% (6 cases)and 39.535% (17 cases)respectively,the difference was significant(χ2 =8.139,P =0.004).The incidence rates of pulmonary infection in the nasal decontamination group and conventional group were 4.348% (2 cases)and 18.605% (8 cases)respectively,the difference was significant(χ2 =4.529,P =0.033). The incidence rates of pharyngitis in the nasal decontamination group and conventional group were 10.870%(5 cases)and 37.209% (16 cases) respectively,the difference was significant (χ2 =8.553,P =0.003 ). Conclusion Nasal decontamination can decrease the positive rate of sputum bacterial culture,the incidence of pulmonary infection and pharyngitis in elderly patients with long -term indwelling nasogastric tube.For its efficacy and safety,it deserves clinical application.

Objective To explore the surgical treatment of carotid body tumor(CBT). Methods The clinical data of 78 patients with CBT were retrospectively analysed. Results Seventy eight patients had 88 tumors (10 patients had bilateral CBT),of which 83 were resected. The operations included:CBT enucleation (28 tumors);CBT resection along with the external carotid artery resection(12 tumors); CBT enbloc resection with partial carotid artery(CA) resection and interposition grafting(3 tumors) or end to end anastomosis (1 tumor), and external to internal CA anastomosis (1 tumor); CBT enbloc resection with CA reconstruction(30 tumors), and CBT resection and CA ligation (8 tumors). The operative mortality was 3.8%(3/78). 65 tumors were followed up for 1～21 years,and one patient died of pulmonary metastasis seven years after the surgery. In the follow up period, 1 patient had a local recurrence two years after the surgery,and reoperation was performed,the patient did well 8 years after the reoperation. One patient with family CBT had an opposite lesion 10 years after the first lesion resection. Conclusions CBT may be bilateral,family occurrence,malignant changes and endocrine secretion charateristics. For small CBT, enucleation can be done first.If CA is involved, external CA remove along with CBT and end to end anastomosis may be a better choice . For tumors invading the internal CA, it is better to resect the lesion with reconstruction of the CA with, an autogenous internal jugular vein graft or prosthesis. For large CBT or CBT adhensed to nearby tissues seriously, end to end anastomosis can be carried out to internal CA at a transversely cutting surface of CBT.