Objective To assess the value of procalcitonin( PCT) in anti-infective therapy by observing PCT concentration change in therapy. Methods Sixty-eight patients with bacterial infection meet the diagnostic criteria were divided into effective group and invalid group,the PCT level on day 1,day 3,day 5 and day 7 were observed respectively. Results PCT concentrations of two groups showed no sig-nificant difference on day 1. The PCT level of effective group gradually declined and PCT level of invalid group gradually rised with significant difference on day 3,day 5 and day 7(P<0. 05). Conclusion PCT level that is positively correlated with inflammation of infectied patients, which can be used as an effective indicator to optimize antibiotic therapy.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cytarabine ; therapeutic use ; Granulocyte Colony-Stimulating Factor ; therapeutic use ; Humans ; Leukemia, Myeloid, Acute ; pathology ; therapy ; Vidarabine ; analogs & derivatives ; therapeutic use

Objective To evaluate the therapeutic effects of early intratympanic steroid of different concentrations and types combined with systemic steroid on severe idiopathic sudden sensorineurl hearing loss(ISSNHL).Methods We reviewed 95 patients with unilateral ISSNHL from January 2012 to June 2016 in the Department of Otolaryngology of the People's Hospital of Changshou and according to the steroid treatment methods,Patients were divided into systemic steroid therapy alone group(group A,30 cases),early intratympanic steroid of low concentration combined with systemic steroid group (group B,32 cases) and early intratympanic steroid of high concentration combined with systemic steroid group (group C,33 cases).Results Total effective rates of the group A,group B and group C were 46.67 ％,56.25 ％,78.79％.Group C was significantly higher than that of group A and group B(P＜0.05);the average pure tone threshold improvement was (46.67±9.32) in group C which was better than group A (20.53±8.83) and group B(25.19± 7.46),the differences were stastically significant (P＜0.01).Conclusion Severe ISSNHL should be treated by intratympanic steroid of high concentration combined with systemic steroid as early as possible in order to rescue the hearing,the efficacy of which is much better than other steroid treatments so far.

Aged ; Humans ; Leukemia, Myeloid, Acute ; diagnosis ; therapy

Benzamides ; Humans ; Imatinib Mesylate ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; blood ; drug therapy ; Piperazines ; pharmacokinetics ; therapeutic use ; Pyrimidines ; pharmacokinetics ; therapeutic use

Clinical Trials as Topic ; Humans ; Leukemia ; drug therapy

Objective To compare the clinical outcomes of percutaneous cannulated lag screws versus posterior buttress plate in the fixation for posterior malleolar fractures.Methods We reviewed the 167 patients who had been treated between January 2010 and December 2014 for ankle fracture involving larger than 25％ of the articular surface of the posterior malleolus.They received posterior malleolus fixation with percutaneous cannulated lag screws or with a buttress plate.In the cannulated screw group (84 patients),there were 47 males and 37 females,aged from 23 to 72 years (average,49.7 ±9.1 years),and 39 cases of type B and 45 ones of type C according to the Dennis-Webber classification.In the buttress plate group (83 patients),there were 38 males and 45 females,aged from 31 to 69 years (average,52.3 ± 8.3 years),and 45 cases of type B and 38 ones of type C according to the Dennis-Webber classification.At 6 and 12 months postoperation and the final follow-up,the ankle motion was evaluated using American Orthopaedic Foot and Ankle Society (AOFAS) score and range of motion (ROM).Results The average operation time for the cannulated screw group was significantly shorter than for the buttress plate group (Z =-9.145,P ＜ 0.001).No fracture nonunion,reduction loss or incision infection happened in either group.In the cannulated screw group,we detected malunion with a step-off beyond 2 mm in 5 patients,and penetration of one cannulated lag screw into the tibiofibular syndesmosis in 3 patients.In the buttress plate group,we detected toe flexion contracture in 4 patients,and uncomfortable feeling in ankle motion in 7 patients.At the final follow-up,X-rays and CT scans in the 2 groups showed no obvious post-traumatic osteoarthritis of the ankle.There were no significant differences between the 2 groups regarding the AOFAS scores at 6 and 12 months postoperation and the final follow-up(P ＞ 0.05);the AOFAS scores at the final follow-up for all the patients were significantly different from those at 6 and 12 months postoperation (P ＜ 0.05).At the final follow-up,there were no significant differences between the 2 groups regarding ROMs of dorsal flexion,plantar flexion,varus or valgus (P ＞ 0.05).Conclusions As there are no significant differences between the percutaneous cannulated lag screws and posterior buttress plate in AOFAS score and ROM of the ankle after fixation for posterior malleolar fractures,the 2 fixation methods can both achieve good clinical outcomes.Fixation with cannulated lag screws has advantages of indirect reduction and minimal invasion but also a disadvantage of uncertain quality of reduction;fixation with buttress plates has an advantage of anatomical reduction under direct vision but also shortcomings of relatively large invasion and high cost.

Objective T o establish a gas chrom atography-m ass spectrom etry (G C-M S ) m ethod for the determ ination of sulfide ion in blood and apply it to the practical cases. Methods T he 1, 3, 5-tribro-m obenzene w as selected as an internal standard, and 0.2 m L blood sam ple w as collected and analyzed using G C-M S after α-B rom o-2, 3, 4, 5, 6-pentafluorobenzyl brom ide derivatization. Results T he m ass concentration of sulfide ion in blood had good linearity in the range of 0.2-40μg/m L w ith a lim it of detection (L O D ) of 0.05μg/m L . T he m ass concentration of sulfide ion w as less than 0.05μg/m L in blank blood from different sources such as healthy subjects and dead cases. In 3 sulfide poisoning cases, sul-fide ion w as detected in the blood sam ples of 6 victim s, and the m ass concentration range w as 1.02-3.13μg/m L . Conclusion T his study establishes a m ethod for investigation of sulfide ion in blood w hich has been applied successfully to the cases of fatal sulfide poisonings.

Objective T o analyse the m etabolic changes in urine of rats w ith brodifacoum intoxication, and to reveal the m olecular m echanism of brodifacoum-induced toxicity on rats. Methods B y establish-ing a brodifacoum poisoning rats m odel, the urine m etabolic profiling data of rats w ere acquired using high performance liquid chromatography-timeofflightmassspectrometry (HPLC-TOF-M S).The orthogo-nal partial least squares analysis-discrim ination analysis (O PLS-D A ) w as applied for the m ultivariate statistics and the discovery of differential m etabolites closely related to toxicity of brodifacoum . Results O PLS-D A score plot show ed that the urinary m etabolic at different tim e points before and after drug adm inistration had good sim ilarity w ithin tim e period and presented clustering phenom enon. C om paring the urine sam ples of rats before drug adm inistration w ith w hich after drug adm inistration, tw enty-tw o m etabolites related to brodifacoum-induced toxicity w ere selected. Conclusion T he toxic effect of brodi-facoum w orked by disturbing the m etabolic pathw ays in rats such as tricarboxylic cycle, glycolysis, sphin-golipid m etabolism and tryptophan m etabolism , and the toxicity of brodifacoum is characterized of accu-m ulation effect. The m etabonom ic m ethod based on urine H PLC-TO F-M S can provide a novel insight into the study on m olecular m echanism of brodifacoum-induced toxicity.

BACKGROUND:Abnormal stress is an important factor causing intervertebral disc degeneration. To establish an ideal in vivoanimal model of intervertebral disc degeneration is of great significance for in-depth study on the related pathogenesis. OBJECTIVE:To develop anin vivo rabbit intervertebral disc model and to investigate the relationship between continuous tensile load and intervertebral disc degeneration. METHODS:Twenty-five New Zealand white rabbits aged 6 months old were randomly divided into three groups: blank control (n=5), sham (n=10) and experimental (n=10) groups. The blank control group received no intervention, and the L4/5 segments were removed at the 1st day. The intervertebral disc assistor was used to fix the L4 and L5 vertebral bodies in the experimental and sham groups, the L4/5 segments in the experimental group were loaded 1 MPa axial tensile force, and the L4/5 segments in both two groups were then removed at 14 and 28 days. The changes of L4/5 intervetebral space height and surrounding bone substance were observed by X-ray examination, the morphological changes of the intervertebral disc were observed by hematoxylin-eosin staining, the cell survival was detected by nitro blue tetrazolium staining and mRNA expression levels of aggrecan, collagen type Ⅱ and SOX9 in the intervertebral disc tissues were assessed by RT-PCR at each time point. RESULTS AND CONCLUSION:The radiological manifestations, histological changes, cell survival and mRNA expression levels of aggrecan, collagen type Ⅱ and Sox9 showed no significant difference between the blank control and sham groups. Comparied with the blank control group, in the experimental group, the L4/5 intervertebral space was narrowed with time, the articular surface was coarse, and the upper and lower corpus vertebrae edge appeared to have lip-shaped hyperplasia; the intervertebral disc cells distributed irregularly; the nucleus pulposus was in dehydration and deflation, annulus fibrosus arranged irregularly, and the vacuoles in notochord cells tended to disappear; the expression levels of aggrecan, collagen type Ⅱ and SOX9 were markedly downregulated. These findings suggest that the in vivo rabbit model of intervertebral disc is successfully established, in which continuous mechanical tensile load is further proved to directly cause intervertebral disc degeneration.