Objective:To explore the efficacy of gamma globulin at different doses combined with dexamethasone in the treatment of children with severe idiopathic thrombocytopenic purpura. Methods: Totally 96 cases of patients with idiopathic thrombocytopenic purpura were divided into group A ( standard high dose of gamma globulin+dexamethasone) , group B ( middle dose of gamma globulin+dexamethasone) and the control group ( dexamethasone) . The clinical effects and platelet parameters of the three groups were com-pared. Results:The levels of PLT, PCT and PDW in group A and group B after the treatment were higher than those in the control group(P<0. 05). The recovery time of normal platelet and the stop time of bleeding in group A and group B were lower than those in the control group(P<0. 05), and there was no significant difference between group A and group B(P>0. 05). The clinical effective rate of group A and group B was higher than that in the control group(P<0. 05), and there was no significant difference between group A and group B(P>0.05). There was no significant difference in the incidence of adverse reactions among the three groups (P>0. 05). Conclusion:Gamma globulin at middle dose shows significant effect as at high dose in the patients with ITP, which can reduce the dosage and is worthy of clinical promotion.

Objective Clinical studies of Chronic Nasosinusitis by endoscopic intranasal sinus surgery under head mirror.Methods 43 cases were operatived by endoscopic intranasal sinus surgery under head mirror.Results 29 cases were cured and 14 cases effectived, Efficiency 100.00%. 17 uncinate process residue, There were no severe complications.Conclusion Endoscopic intranasal sinus surgery under head mirror for chron icsinu sit is and nasal polyps can solveo stiom eatalcomplex anom alism more effectively and raise the cure rates of sinusitis (type Ⅰ、Ⅱ) than conventional technique in surgery.This choice will reduce the cost of the patients than Endoscopic sinus surgery, but must be provided with the knowledge in nasal and paranasal sinus, grapple the gist of endoscopic intranasal sinus, strict Surgical indication at the same time.

Objective To investigate the difference of leucorrhea routine tests results among 3 periods of pregnancy in pregnant women.Methods Vaginal cleanliness,the presence of clue cells,trichomonas and fungi were tested for 3 103 obstetric outpatients who were pregnant and treated in the hospital.The test results were analyzed and compared.Results Among pregnant women in different periods of pregnancy,the difference in the proportion of vaginal cleanliness degree Ⅲ and fungal infection rates were statis-tically significant(P <0.05).Among pregnant women of different pregnant periods with vaginal cleanliness degree Ⅱ,difference of fungi infection rate was statistically significant(P <0.05).Among pregnant women of different pregnant periods with vaginal clean-liness degree Ⅳ,the difference of positive rates of fungi,trichomonas and clue cells were statistically significant(P <0.05).In addi-tion,there are a number of mixed infections.Conclusion Vaginitis during pregnancy should be early detected,diagnosed and trea-ted.

According to the pharmacokinetic theory, the authors studied the accumulation of gentamycin in perilymph of guinea pigs by searching the drug concentration at various time with Fluorescene Polarization Immunoassay (FPIA). The results indicated that: (1) The drug concentration in perilymph increased with the augment of total doses administered and there was almost a linear correlation between them. (2) In animals of 7-day injectious group, the drug could be still detected during 72 hours after the last dose administration. The concentration was 1 37?0.95 ?g/ml which was close to the level of serum minimal inhibitory concentration (MIC). It suggested that the elimination of the drug from inner ear was too slow and evident accumulation of gentamycin was indeed. (3) The fact mentioned above implied that the drug ototoxities could still damage the ear even if the drug administered had ceased before. It is the reason by which we could explain the problem encountered in clinic, that is why in some patients the ototoxic syndrom may still presented or enhanced even though the treatment has been stopped a few days before.

Objective To evaluate the distribution and drug resistance of bacteria causing neonatal infectious pneumonia in Jiaxing,and to provide a therapy for clinical doctor to make a correct diagnosis,choose reasonable anti-biotics and avoid abuse of antibiotics.Methods Took expectoration from trachea in condition of asepsis to conduct culture and perform drug-sensitive test from 3025 cases.Results Totally 1 156 strains of aerobic bacteria were iso-lated.875 strains were gram negative bacilli(75.7%),269 strains were gram positive cocci(23.3%),and 12 strains were fungi(1.0%).Klebsiella pneumoiae,Escherichia coil,Acinetobacter baumanni,Enterobacter cloacae were com-mon in gram negative bacilli( respectively 178 cases,151 cases,87 cases,113 cases) .The proportion of the Staphylo-coccus aureus was the largest in gram positive cocci(245 cases) .The results showed that gram-negative bacilli were resistant to cefazolin, ampicillin, piperacillin and sensitive to meropenem, imipenem, piperacillin-tazuobatanna and cefoperazone-sulbactam.The drug resistance was severe of ESBL-positive.Staphylococcus aureus was resistant to penicillin, ampicillin, erythrocin, clindamycin and sensitive to linezolid, vancomycin, nitrofurantoin.Conclusion Gram-negative bacilli are the main bacteria in neonatals with infectious pneumonia.The drug resistance is severe.It is important to make a standard management and isolation.

Objective Detect the infection rate of herpes simplex virus (HSV ) by jointly using chemiluminescence assay and PCR ,and provides reference for clinical diagnosis .Methods The serum samples were collected from the pregnant women who had routine examination records in the hospital .Chemiluminescence assay was used to detect HSV IgM and IgG in those samples .Cervi‐cal secretions were collected from pregnant women with positive results and qualitatively tested for HSV DNA .Results The posi‐tive rate of HSV1 DNA was 0 .5% (7/1 422) ,the positive rate of HSV2 DNA was 1 .1% (16/1 422) .For pregnant women whose HSV IgM and IgG were both positive ,positive rate of HSV1 DNA was 0 .4% (4/1 008) and that of HSV2 DNA was 0 .6%(6/1 008);for those who only had HSV IgM positive ,the positive rate of HSV1 DNA was 0 .8% (1/130) ,and that of HSV2 DNA was 3 .1% (4/130);for those who only had HSV IgG positive ,the positive rate of HSV1 DNA was 0 .7% (2/284) ,that of HSV2 DNA was 2 .1% (6/284) .Among those three HSV antibody positive cases ,the difference in HSV1 DNA positive rate was not sta‐tistically significant(P>0 .05) ,while the difference in HSV2 DNA positive rate was statistically significant(P<0 .05) .Conclusion The test of HSV antibodies during pregnancy can be used as a routine test ,and HSV DNA test can be used as further test for those with HSV antibody positive ,which could improve the accuracy of diagnosis .Early screening ,detection ,and treatment are im‐portant for pregnant women with HSV infection .

Angiopoietin-2 levels were 5. 80 ( 3. 83-8. 00 ) , 4. 42 ( 2. 56-5. 55 ) , and 2. 75 ( l. 40-4. 64 )ng/ml in type 2 diabetic patients with proliferative retinopathy, patients with non-proliferative retinopathy, and patients without retinopathy, respectively. Statistical significances existed between any two groups (all P ＜0. 01 ). Angiopoietin-1 level in patients with non-proliferative retinopathy was higher than that in patients without retinopathy [10. 57 ( 8. 99-12. 05 ) vs 9. 21 (7. 71-11.2 ) ng/ml, P＜0. 05]. No difference in receptor Tie-2 was found among the 3 groups (P＞0. 05 ). The results suggested that serum angiopoietin-2 level might be associated with the severity of retinopathy in type 2 diabetic patients.

Objective To explore the value of the application of vascular enhancement technology (VET) in the diagnosis of Budd-Chiari syndrome (BCS) and the evaluation of the therapeutic efficacy of interventional therapy.Methods B-mode ultrasound,color Doppler and VET were performed on 93 patients with BCS for the systematic detection of intrahepatic vessels and the inferior vena cava (IVC),with the static and dynamic images of these vessels stored prior to interventional therapy.Subsequent to the operation,the same procedures were repeated on the vessels concerned and the images were recorded.The definitions of B-mode and VET images of the detected vessels were compared by two sonography experts.Regarding DSA as standard,the diagnostic accordance rate of VET and B-mode imaging of the diseased vessels was compared.Results Of the 613 vessels detected prior to intervention therapy,440 vessels images were distinct by B-mode and 533 by VET(P<0.05).VET demonstrated 37 intrahepatic collaterals which were invisible by B-mode.Regarding DSA as the gold standard,the diagnostic accordance rate of affected vessels of B-mode and VET was 69.2% and 92.5%,respectively(P<0.05).In total 103 therapeutic vessels,B-mode sonography and VET revealed 81 and 95 distinct vessels,respectively(P<0.05).Conclusions VET can improve the definition of veins and venous stents.The combination of VET and color Doppler can improve the clinical value of ultrasound in the diagnosis of BCS and evaluation of the therapeutic efficacy of interventional therapy.

Objective To investigate the correlation between the expression of mononuclear cells Inter-leukin-18(IL-18)and early renal damage in diabetic patients.Methods 480 cases with type 2 diabetes mellitus (T2DM)in our hospital from Jan.2010 to Dec.2012 were selected.According to urine albumin excretion rate, They were randomly divided into diabetic group, micro proteinuria group, and proteinuria group.160 cases of normal people were selected as the control group.Glycosylated hemoglobin, serum cholesterol, serum triglycer-ides, serum creatinine, blood urea nitrogen.2 h postprandial blood glucose and urine protein were detected.Af-ter mononuclear cells being isolated and cultured for 12 h and 24 h, IL-18 was detected.-137G/C and-607C/A gene polymorphism were detected.Results Normal group were significantly lower than diabetes group, micro proteinuria group, and proteinuria group(P<0.01)in BMI, 2 h postprandial blood sugar, cholesterol, glycosy-lated protein, urea nitrogen and serum creatinine index.Micro proteinuria group and proteinuria group were high-er than diabetic group in 2 h blood sugar, cholesterol, glycosylated protein, urea nitrogen and serum creatinine index(P<0.05).Diabetes group, micro proteinuria group, and proteinuria group were significantly higher than normal group in urine protein, 12 h IL 18 and 24 h IL-18(P<0.01).Micro albuminuria and proteinuria group was significantly higher than diabetic group in urine protein, 12 h IL 18 and 24 h IL-18(P<0.01).There were positive correlation between urine protein and 12 h, 24 h IL-18(r=0.454, P<0.01; r=0.479, P<0.01). There was statistical difference between albuminuria group and diabetes group in -137G/C genotype frequency (χ2 =5.45, P<0.05) and there was statistical differencebetween the allele frequency distribution(χ2 =5.76, P<0.05) .Conclusions IL-18 can be used as an indicator for detecting early renal damage.Gene -137G/C polymorphism may increase the risk of diabetic nephropathy by upregulating the expression of IL-18.

Objective:To analyze the nosazontology of pharyngeal paraesthesia and investigate the treatment. Method: Two hundred and twelve misdiagnosed pharyngeal paraesthesia patients were investigated by history inquiry,routine examination, 24-hour esophageal pH monitoring, barium X-ray of the oesophagus, anxietas-athy-mia private measuring scale, coefficient of variation of the R-R(CVR-R), bioavailable testosterone detection(Bio-T), erection experiment and questionnaire about man climacteric syndrome. The concomitant symptoms and positions of pharyngeal paresthesia were also studied. We adopted individuallied sequential multi-therapy for every patient according to the cause of disease. Result:The cause of disease within 212 cases of pharyngeal paraesthesia included 62 psychictrauma,32 endocrine system disease,106 upper gastrointestinol disease, circulatory disease,9 circulatory disease,3 idiopathic. With individualized treatment, 110 cases had fully recovered, 63 cases excellence and 31 cases utility,and the efficiency rate was 96.23%. Conclusion:Pharyngeal paraesthesia can be caused by several factors. Thorough examination and comprehensive analysis should be applied to those incurable patient who has been treated for a long time. Short course of treatment and irrational drug use are the main causes of short term recurrence and unsatisfactory curative effect.