The clinical characteristics, therapeutic effects and complications of 32 incipient patients with acute Vogt-Koyanagi-Harada ( VKH) syndrome admitted in Wuxi Second Hospital during October 2010 to September 2013 were retrospectively analyzed.There were 15 males and 17 females with a mean age of (41.3 ±14.1) years (22 -71 years), the time from the disease onset to treatment ranged from 3 to 20 days.Among 32 cases, 30 ( 94%) had premonitory symptoms. The multifocal bullous neurosensory detachment, optic disk hyperemia and edema in posterior pole of fundus were found in all cases, and exudative retinal detachment was found in 4 cases (6 eyes).The results of optical coherence tomography ( OCT) showed the macula neurosensory detachment, thick retinal neuroepithelial layer and wavy RPE layer in all patients.Fundus fluorescein angiography ( FFA) showed that scattered hyperfluorescence dots and cystic fluorescein reservoir was observed in early phase and later period respectively.Patients received intravenous methylprednisolone with the onset dose of 80 mg per day for 3-7 days and oral administration followed, which would gradually decrease later;the average treatment duration was (52.9 ±14.6) weeks. The visual acuity of 40 eyes (22 cases) was recovered to more than 0.8, and no blindness occurred after the treatment.During the treatment hair loss, depigmentation of skin and hair were found in 12 cases (38%) , and 2 cases showed short-term elevated intraocular pressure.These symptoms disappeared after drug therapy ceased.And no recurrence was found during the follow-up of 6 months.However, sunset glow fundus was found in 13 patients (26 eyes).The study shows that the diagnosis of VKH syndrome is based on the typical signs of the fundus presented on OCT and FFA.Early and systemic administration of glucocorticoids is important treatment for patients with VHK syndrome, which could decrease systemic and local complications effectively.

Coxsackievirus A(CV-A)is a common virus associated with a number of serious human diseases,including menin-gitis,myocarditis,herpangina,conjunctivitis and hand,foot and mouth syndrome. In recent years,with the increase of epidemics events with CV-A as the main pathogen,the studies focusing on the CV-A infection have attracted more attention. In this paper,we comprehensively review the basic characteristics,pathogenesis and potential antiviral drugs of CV-A.

Subglottic pleomorphic adenoma is a rare disease . Surgery is the main curative treatment. To review some clinical cases and to summarize the characteristics and treatment experience of this disease,it is expected that we can provide more clinical thought and therapeutic strategy for subglottic pleomorphic adenoma.
Adenoma, Pleomorphic ; therapy ; Humans ; Hypothermia, Induced ; Rare Diseases

Objective: To explore the molecular biological mechanism of acupuncture in intervening visual deprivation.
Methods: Forty-eight 2-week old Wistar rats were randomly divided into a normal group, a model group, and 6 acupuncture groups (group C1: acupuncture at the unaffected side in early stage; group C2: acupuncture at the affected side in early stage; group D1: acupuncture at the unaffected side in mid-stage; group D2: acupuncture at the affected side in mid-stage; group E1: acupuncture at the unaffected side in late stage; group E2: acupuncture at the affected side in late stage) by the random number table, 6 rats in each group. Rats in the normal group didn’t receive any interventions. The rat model of deprivation amblyopia was established by unilateral eyelid suture in the model group and each acupuncture group. After successful modeling, rats in model group didn’t receive any treatments; rats in the acupuncture groups received acupuncture intervention which began respectively on the 3rd, 12th and 21st day after modeling. Pattern visual evoked potential (P-VEP) and N-methy D-aspartatreceptor-1 (NMDAR1) mRNA expression in visual cortex area 17 were detected at the end of acupuncture intervention in each group.
Results: After the intervention, the P-VEP waveform was significantly changed, with a significantly delayed P100 value (P<0.01) and significantly decreased amplitude of N45-P100 in the model group versus the normal group (P<0.01); the P-VEP waveform was significantly improved, with obviously earlier P100 (P<0.01) and increased amplitude of N45-P100 (P<0.05) in each acupuncture group versus the model group. The improvement effect of acupuncture on the P-VEP waveform in group C1 and C2 was more significant than that in group D1, D2, E1 and E2. The expression of NMDAR1 mRNA of the rat visual cortex area 17 in the model group was significantly lower than that in the normal group (P<0.01); and the expression of NMDAR1 mRNA in the visual cortex area 17 of each acupuncture group was significantly higher than that in the model group (P<0.05); the effect of acupuncture on NMDAR1 mRNA expression in group C1 and C2 was more significant than that in group D1, D2, E1 and E2; and the effect of acupuncture on NMDAR1 mRNA expression was better in group C2 than in group C1 (P<0.05); there was no significant difference in the expression of NMDAR1 mRNA between group D1 and D2, neither between E1 and E2 (P>0.05).
Conclusion: P-VEP waveform is abnormal and NMDAR1 mRNA expression in visual cortex area 17 is decreased in rats with monocularly-deprived amblyopia. Acupuncture in the sensitive period can significantly regulate the abnormal P-VEP waveform and the down-regulate the NMDAR1 mRNA expression of the visual cortex of rats with monocularly-deprived amblyopia. Early treatment in the sensitive period should be the key to obtaining the curative effect.

Objective To evaluate feasibility and reliability of using Simplified Acute Physiology Score Ⅱ (SAPS Ⅱ)in predicting mortality in critically ill patients with neurological diseases.Methods All 653 patients hospitalized in neurological intensive care unit (N-ICU) from Jan 2005 to Dec 2007 were retrospectively studied.SAPSⅡ scores were scaled upon admission at 24,48 and 72 h,and possibility of hospital mortality (PHM) was calculated based on SAPS Ⅱ score.Neurological diseases diagnosis made initially at time of hospitalization was classified into five categories:intracranial hemorrhage,cerebral infarction,neurologic infection,neuromuscular diseases and other neurologic diseases.At each of four time points,the SAPSⅡscores were compared between the survival group and death group,and the relationship of SAPS Ⅱ score and prognosis were analyzed.The calibration of the SAPS Ⅱ were accessed with the Hosmer-Lemeshow goodness-of-fit chi-squared statistic and the discrimination with area under the receiver operating characteristic curve (AUROC).Multivariate logistic regression was used to analyze the relationship between disease category and prognosis.Results SAPS Ⅱ scores in the death group (46.53±12.22,47.28±13.84,48.58±14.18 and 49.06±14.61)at each time point were significantly higher than those in the survival group (34.70±11.78,30.28±12.24,29.79±12.36 and 29.69±12.96;t=11.12,14.02,14.43 and 13.49 at 0,24,48 and 72 h,respectively,P＜0.01).Furthermore,univariate logistic regression analyses demonstrated that SAPS Ⅱ score was correlated with prognosis (OR=1.080,1.100,1.109,1.100 at 0,24,48 and 72 h,respectively,P＜0.01).The scores at 48 and 72 h were more accurate in predicting mortality.SAPS Ⅱ had good calibration at each time points (x2=5.305,7.557,6.369 and 8.540,P＞0.05),however,the consistency of expected mortality with observed mortality was satisfactory only at 48 and 72 h(82.6%,83.4%),so was the discrimination ( AUROC=0.825,0.847 respectively).There was no correlation between disease categories and outcome.Conclusion SAPS Ⅱ scoring,best evaluated at 48 and 72 h after hospitalization,can be used as a reliable predictor of probability of mortality in patients hospitalized in N-ICU and prediction can be applied in these patients with all different neurology diseases.

in order to maintain a normal temperature range.

Objective To investigate the distribution and drug resistance of pathogens isolated from urine culture in 2013 and provide basis for clinical treatment .Methods MicroScan WalkAway 96 PLUS bacterial identification system was used to identify the pathogens and drug susceptibility testing .The data were analyzed by WHONET 5 .6 software .Results A total of 231 strains of pathogens were isolated from urine cultures ,including 51(22 .1% ) strains of gram‐positive bacteria ,170(73 .6% ) strains of gram‐negative bacteria ,and 10(4 .3% ) strains of fungi;Escherichia coli ,the coagulase‐negative Staphylococcus ,Klebsiella pneumoniae and E .faecalis were ranked the top four species of pathogens ,accounting for 48 .9% ,13 .0% ,9 .5% ,5 .2% ,respectively .MRCNS among CNS were 73 .6% .Staphylococcus had 100 .00% sensitivity to vancomycin and linezolid ;the antimicrobial resistance rate of E .fae‐calis to ampicillin was 8 .3% .E .faecalis had 100 .00% sensitivity to vancomycin and linezolid .the detectable rates of Escherichia co‐li ,Klebsiella pneumoniae of ESBLs were 52 .2% and 50 .0% ,and the strains had 100 .00% sensitivity to imipenem and meropenem . Conclusion Escherichia coli is a major pathogen in urine culture ,Bacterial resistance is serious .

Myelodysplastic syndromes (MDS) are a heterogenous group of hematologic malignancies characterized by clonal expansion of BM myeloid cells with impaired differentiation. Of particular interest mutations is the recent recognition that genes involved in the regulation of histone function (EZH2, ASXL1,and UTX) and DNA methylation (DNMT3A,IDH 1/IDH2,TET2) are recurrently mutated in MDS,providing an important link between genetic and epigenetic alterations in this disease. Ongoing analysis of the seminal AZA-001study has taught many important lessons in the use of DNA methyltransferase (DNMT) inhibitors.Improved survival in patients with high-risk MDS treated with azacitidine extends to patients with any International Working Group-defined hematologic response.New information on the impact of DNMT inhibitors on the immune system and on stem cells will likely lead to novel uses of these drugs in MDS and other hematologic and nonhematologic malignancies. The immunomodulating drug thalidomide and its derivative lenalidomide have been used in the treatment of MDS,principally in lower-risk MDS.

Objective To investigate the distribution and antimicrobial resistance of the clinical isolates from Children's Hospital of Chuzhou during 2014.Methods A retrospective analysis was conducted with the bacterial strains isolated from various clinical specimens in 2014.Results A total of 382 clinical isolates were collected during 2014, of which gram positive organisms and gram negative organisms accounted for 37.4 % and 62.6 %, respectively. The top 5 most frequently isolated microorganisms were E. coli (18.8 %),K. pneumoniae (16.8 %), coagulase negative Staphylococcus (13.1 %),S. pneumoniae (9.4 %) and S. aureus (9.2 %). The prevalence of MRSA was 28.6 % in S. aureus and the prevalence of MRCNS was 76 % in CNS. All staphylococcal strains were susceptible to daptomycin, linezolid and vancomycin. All the E. faecalis and E. faecium isolates were sensitive to daptomycin, linezolid and vancomycin. All the S. pneumoniae strains were susceptible to penicillin. The prevalence of extended spectrum-lactamases (ESBLs) positive strains was 58.3 % in E. coli and 28.1 % in K. pneumoniae. The Enterobacteriaceae strains were highly sensitive to carbapenems. Only 3 (1.6 %) carbapenem-resistant strains were identified in the Enterobacteriaceae isolates. About 13.3 % and 6.7 % of theP. aeruginosa isolates were resistant to piperacillin and levofloxacin, respectively. All the P. aeruginosa strains were sensitive to the other antimicrobial agents. The percentage of carbapenem-resistantAcinetobacter strains was lower than 10 %. Only one carbapenem-resistant A. baumannii strain was identified.Conclusions Gram negative microorganisms account for most part of the clinical bacterial isolates in 2014. The antimicrobial resistance is still very serious in this hospital, especially the emergence of carbapenem-resistant Enterobacteriaceae, which is of great concern.

The information commons concept-based stereoscopic resources support system for academic library with brand-new connotations and its application were proposed according to the increasing development and expansion of informationization, networking and digitization in different social fields, the significant change in disseminating methods of information resources, and the need of readers for library service.