Objective The paper discussed the clinical value of differential diagnosis of pleural effusion by combined examination of exfoliative cytology and tumor markers,such as Carcinoembryonic-antigen(CEA),Carbohydrate-antigen1 9-9 (CA1 9-9),Cytoker-antin-1 9-fragment 21-1 (CYFRA21-1)and carbohydrate antigen 125 (CA125).Methods A total of 21 6 patients with pleural effu-sion were divided into malignant group containing 1 96 patients and benign group consisting of remaining patients.Aside from the conventional exfoliative cytology examination,by electrochemical luminescence immunoassay technology,the contents of tumor markers of CEA,CA1 9-9,CYFRA21-1,CA125 in the pleural effusion were measured.Finally,the data were statistically analyzed. Results In malignant group,the positive rate of exfoliative cytologic examination was 82.7%,in which adenocarcinoma accounted for 87.7%.The tumor markers in malignant group was significantly higher than that of benign group.The difference was statisti-cally significant (P < 0.05 ).The sensitivity of CEA is 52.0%,CA1 9-9 48.5%,CA125 41.9%,and the four tumor markers is 74.5%,respectively.For the combined examination of exfoliative cytology and tumor marke,the sensitivity is 96.4%,and specifici-ty is 80%,accuracy is 96.8%.Conclusion The exfoliative cytologic examination is one of the best ways to diagnose malignant pleu-ral effusion.The tumor marker detection is a useful auxiliary method for correct diagnosis and treatment.The sensitivity and accura-cy of the diagnosis of benign and malignant pleural effusion can be improved by the exfoliative cytologic examination combined with tumor marker detection.

Objective To evaluate the efficacy and safety of desloratadine citrate disodium versus epinastine for the treatment of chronic urticaria (CU).Methods A randomized,double-blind,double-dummy controlled clinical trial was conducted.Patients with CU were divided into test group and control group to be treated by oral desloratadine citrate disodium (8.8 mg/d) and epinastine (10 mg/d) respectively once a day for 28 days.All the patients were followed up after starting treatment.Therapeutic effect was evaluated,and adverse reactions were observed.Results One hundred and fifty-seven patients were enrolled in this study,and 142 patients were valid for evaluation of efficacy and safety at the end of study.After treatment for 28 days,there was no significant difference between the test group and control group in response rate (81.16 ％ vs.78.08 ％,P ＞ 0.05) or incidence rate of adverse reactions (13.89 ％ vs.12.16 ％,P＞ 0.05).Conclusion Desloratadine citrate disodium is effective and safe for the treatment of CU.

Objective To investigate the cerebral CT appearances of toxic encephalopathy of tetramine and improve the recognition on this disease. Methods Four cases of toxic encephalopathy of tetramine were collected and their cerebral CT appearances were retrospectively analyzed. Results Cerebral CT appearances in acute phase (within 8 days): (1) cerebral edema in different degree. CT abnormalities consisted of cortical hypodensities and complete loss of gray-white matter differentiation. The CT value were in 11-13 HU, and to be watery density in serious case,(2)subarachnoid hemorrhage. It demonstrated the signs of poisoning hypoxic ischemic encephalopathy in chronic phase. Conclusion The cerebral CT appearances of toxic encephalopathy of tetramine had some character in acute phase and it can predict the serious degree of intoxication, but there was no characteristic findings in chronic phase.

Objective: To explore automatic breast full volume imaging (ABVS) and color doppler ultrasound (CDFI) for breast cancer neoadjuvant chemotherapy (NCT) in the evaluation of curative effect. Methods:The application of a CDFI and ABVS 42 cases of breast cancer patients receiving NCT lesions imaging characteristics before and after observation and analysis. Results:ABVS from coronal distribution and audio-visual change according to the primary tumor, and CDFI images showing the primary tumors and blood flow changes within all have significant difference in patients with complete remission after NCT (P<0.01);ABVS from coronal distri-bution and audio-visual change according to the primary tumor, and CDFI showed lesions in blood flow changes, etc. in patients with the absence of change and easing some lesions have no significant difference (P>0.05). Conclusion:We use ABVS and CDFI for breast cancer before and after the NCT curative effect evaluation of great clinical significance and value.

Objective To compare the disinfection efficacy of different disinfectants on dental unit waterlines (DUWLs). Methods 18 sets of DUWLs were randomly divided into 4 groups,and disinfected or treated with hydrogen peroxide (H2 O2 )disinfectant,sodium hypochlorite (NaClO)disinfectant,hydrogen peroxide silver ion disinfectant(Sanosil),and distilled water (DW)respectively.Water specimens from triple syringes and high-speed handpieces were taken,bacterial count before and after disinfection were compared.Results Before disinfection,no significant differences in bacterial counts were found among four groups (all P >0.05),bacterial counts of DUWLs of all groups severely exceeded the standard(all>3 000 CFU/mL).After disinfection,except DW group,bacterial counts of DUWLs of the other groups declined dramat-ically (all <100 CFU/mL),bacterial count after disinfection were all obviously lower than before disinfection (all P <0.001 ).One week after disinfection,bacterial counts among three disinfectant groups in different time periods were statisti-cally different (triple syringes:Day1—Day5,all P <0.05;high-speed handpieces:Day2,Day3 and Day5,all P <0.05). Day3 after disinfection of triple syringes by H2 O2 and NaClO,Day4 after disinfection of high-speed handpieces by H2 O2 and NaClO,and Day5 of triple syringes and high-speed handpieces by Sanosil all exceeded the standard of Center for Disease Control and Prevention of America.One week after disinfection,bacterial counts of three disinfection groups all exceeded or approximated to that before disinfection.Conclusion Three types of disinfectants can all effectively reduce bacterial load in DUWLs.Compared with other disinfectants,Sanosil has advantage of inhibiting bacterial growth after disinfection.

Objective To apply iTRAQ technology to observe changes in protein expression group in the process of inducing C2C12 cells differentiation towards osteoblast by BMP-2.Methods The myoblast C2C12 cells were seeded in BMP-2 induced differentiation system for differentiation induction.In the 7th day,differentiation protein was extracted and labeled with iTRAQ reagent.Then,mass spectrometric detection,data analysis of differentially expressed proteins,and analysis of biological information were carried out.Results 23 significantly differentially expressed protein spots were screened by BMP-2-induced myoblast C2C12 differentiated cell protein expression profile analysis,where the protein was labeled with iTRAQ reagent.8 protein points were up-regulated,and 15 protein points were down-regulated.Trend classification found that the above differential protein had differential expression in each period of C2C12 cell osteogenic differentiation (1-7 days).Part of up-regulated protein in the early differentiation period showed high expression level;part of up-regulated protein in the late differentiation period showed high expression level;similarly,part of down-regulated protein in the early differentiation period presented low expression level;part of down-regulated protein in the late differentiation period showed low expression level.Preliminary identification showed SERCA3,Cytochrome bS,S100A4,ATPase inhibitor and ATPIF1 presented dynamic changes,which suggests that these proteins may be related to inducing osteogenic differentiation mechanism.Conclusion The results of differential protein expression trend show the necessity of full monitoring of C2C 12 cells osteogenic differentiation and indicate that iTRAQ technology is an effective method of studying protein changes of cellular molecule.Five proteins including SERCA3,Cytochrome b5,S100A4,ATPase inhibitor and ATPIF1 can be used as candidate targets for osteogenic differentiation mechanism research.

This paper introduces the development and implementation of hospital-community interactive nursing mode for patients with diabetes. The interactive mode between community and hospital,specialist nurses and community nurses,as well as patients and nurses was formed to provide timely,convenient,continuous and whole-process nursing care for diabetic patients through the setting up and services of hespital-based diabetes care team,two-way transfer center between hospital and commu-nity,hospital-based education and community-based visit team,community-based self-management group as well as green chan-nel of priority treatment,inspection and hospitalization for diabetic patients. The implementation of the interactive mode achieved good effect and was approved by the patients. The patient satisfaction rate was 96.5%.

Objective: To explore the association between dietary supplementation during pregnancy and low birth weight. Methods: 11 311 pregnant women who had regularly visited outpatient gynecology clinic of Wuhan Women and Children Medical Center with intention to delivery in the hospital were recruited in the cohort between September 2012 and October 2014. Social-demographic characteristics of pregnant women and spouses, dietary supplementation during pregnancy, pre-pregnancy body mass index (BMI), exercise in the third trimester, work during pregnancy, pregnancy complications and related pregnancy information were collected through self-designed questionnaires, maternal health manuals and medical records. Birth weight of the newborns was measured. Non-conditional multivariate logistic regression analysis was used to determine the correlation between dietary supplementation and low birth weight. Results: 11 311 pregnant women were (28.21±3.70) years old, and they gave birth to 477 low birth weight newborns (4.2%). Iron supplementation during the whole period of pregnancy (OR (95%CI): 0.60 (0.43-0.63)) and folic acid supplementation during the early pregnancy (OR (95%CI): 0.74 (0.60-0.90)) were negatively associated with low birth weight. Conclusion Supplementation of iron during the whole period of pregnancy and folic acid during the early pregnancy would reduce the risk of low birth weight.

Objective: To analyze the antimicrobial resistance profile in Chinese children. Methods: This was a prevalence survey. From January 1 through December 31, 2016, the isolates were collected from 10 tertiary children hospitals in China. Antimicrobial susceptibility testing was carried out by routine laboratory methods. The penicillin susceptibility of streptococcus pneumonia and Meropenem susceptibility of gram-negative bacteria were detected by E-test and disk diffusion method respectively. Antimicrobial susceptibility results were interpreted according to the criteria of Clinical and Laboratory Standards Institute (CLSI) Guideline 2016. The data of antimicrobial susceptibility testing of isolates from either the different patients (neonatal group and non-neonatal group) or various sources were analyzed by WHONET 5.6 software. Results: A total of 56 241 isolates were collected, of which 41.5% (23 328 isolates) were gram-positive organisms and 58.5% (32 886 isolates) gram-negative organisms. The five leading pathogens were Escherichia coli (7 995/56 214, 14.2%), Straphylococcus aureus (6 468/56 214, 11.5%), Streptococcus pneumonia (6 225/56 214, 11.1%), Haemophilus influenza (5 435/56 214, 9.7%) and Klebsiella pneumonia (4 523/56 214, 8.0%). The Meropenem resistance rates of Klebsiella pneumonia, Enterobacter cloacae, Escherichia coil, Pseudomonas aeruginosa, Acinetobacter baumonia isolates were 27.4% (326/1 189) , 8.1% (29/358) , 2.0% (27/1 362) , 19.5% (34/174) , 49.7% (230/463) in neonatal group and 15.4% (512/3 327) , 4.8% (40/841) , 2.3% (151/6 564) , 13.7% (252/1 840) , and 53.4% (860/1 611) in non-neonatal group. The Methicillin-resistant Staphylococcus aureus (MRSA) rates of neonatal group and non-neonatal group were 46.2% (649/1 404) and 33.3% (1 668/5 010) . The penicillin non-susceptible rates of Streptococcus pneumonia in the two groups were 17.6% (6/34) and 18.2% (1 121/6 158) respectively. The β-lactamase positive rates of Haemophilus pneumonia isolates in the neonatal group and non-neonatal groups were 33.8% (47/139) and 44.4% (2 345/5 282) respectively. Conclusion This investigation highlights the worrisome trend of antimicrobial resistance in children, especially among neonatal patients in China.

Objective: To describe the clinical characteristics of pneumococcal infections and drug resistance of Streptococcus pneumoniae isolates from children's hospitals, which would provide reference for preventing and treating pneumococcal diseases. Methods: This was a prevalence survey. In this study, the age, specimen type, monthly distribution characteristics, and antimicrobial resistance of Streptococcus pneumoniae isolates from 9 children's hospitals in China were investigated between January 1, 2016 and December 31, 2016. The WHONET 5.6 software was used to analyze the antibiotic susceptibility of Streptococcus pneumoniae. The comparison of rates was performed by Chi-square test. Results: A total of 6 200 isolates of streptococcus pneumoniae were obtained, namely, 95.1% (5 876/6 177) from the respiratory tract specimens, 2.2% (136/6 177) from blood specimens and 0.4% (24/6 177) from cerebrospinal fluid specimens. The isolates were mainly from children older than 1 and younger than 5 years (54.7%, 3 381/6 185) . Most of strains (33.2%, 1 184/3 563) were isolated in November, December and January. Streptococcus pneumoniae isolates were completely sensitive to vancomycin (100.0%, 6 189/6 189) , linezolid (100.0%, 6 030/6 030) , moxifloxacin (100.0%, 3 064/3 064) , highly sensitive to levofloxacin (99.8%, 5 528/5 540), ertapenem (98.8%, 3 024/3 061) and lowly sensitive to erythromycin (1.7%, 102/6 016), clindamycin (3.7%, 116/3 136), and tetracycline (5%, 244/4 877), respectively. According to the parenteral susceptibility breakpoints for non-meningitis isolates, the sensitivity of Streptocococus pneumoniae to penicillin from children's hospital of Chongqing Medical University (49.3%, 892/1 809) was significantly lower than those of other hospitals (χ²=1 268.161, P<0.05) . Conclusions Streptococcus pneumoniae is mainly isolated from respiratory tract, from children older than 1 and younger than 5 years and during November to January in tertiary children's hospital of China. The Streptococcus pneumoniae from children is highly sensitive to vancomycin, linezolid, moxifloxacin, levofloxacin. There are also significant differences in the sensitivity of penicillin for Streptococcus pneumoniae from different hospitals.