We retrospectively analyzed 23 cases of histiocytic necrotizing lymphadenitis (HNL) admitted to our hospital as fever of unknown origin (FUO).Fever,lymphadenopathy and skin rash were the most common clinical manifestation.The major laboratory features included cytopenia,abnormal liver enzyme and elevated inflammatory markers.Three of the 23 cases were finally diagnosed as infectious disease,5 as autoimmune disease,while the left 15 remained as HNL during the follow-up.Four of the 15 HNL patients resolved spontaneously,while the other 11 relieved by steroid use.Two patients relapsed during the follow-up.HNL was one of the rare causes of FUO.Since it would be accompanied with infectious,autoimmune or malignant diseases,long follow-up is necessary.

The developing process of thermal comfort was analyzed based on physiology and psychology and the relationship between thermal comfort and human health, environment was discussed in this paper.It suggested that the thermo-stable and thermo-comfortable environment, which might decrease body's adaptability to environment, were not necessarily good for human health. It might have some impacts on human's physiological and psychological adaptabilities also to live in the environment with a great difference between the indoor and outside temperature simultaneously and alternately.

Objective To analyse the causes of shunt obstructions after ventriculoperitoneal shunting for children hydrocephalus and their therapy. Methods Ventriculoperitoneal shuntings were done in 156 children with hydrocephalus, in 26 cases of them, the shunts were obstructed. Surgical interventions were performed, and causes of obstruction were found and corrected. Results There were eight kinds of obstructive causes in the ventricular catheters, three kinds in the peritoneal catheters. All obstructions were corrected surgically, 26 patients recovered soon without complications and mortality.Conclusion If the causes of ventriculoperitoneal shunt obstructions can be found and corrected in time, the prognosis of patients is good.

Objective To investigate the thermostability of aristolochic acid Ⅰand the effect of the compatibility on aristolochic acid Ⅰ in Caulis Aristolochiae Manshuriensis decoction and to explore the detoxification mechanism of compatibility for aristolochic acid Ⅰ.Methods Analyzing the contents of aristolochic acid Ⅰ by HPLC in the single decoction of Caulis Aristolochiae Manshuriensis,the concoction of Caulis Aristolochiae Manshuriensis with Cortex Moutan,the residues of decocted Caulis Aristolochiae Manshuriensis and the residues of concocted Caulis Aristolochiae Manshuriensis with Cortex Moutan,respectively.Results Aristolochic acid Ⅰ decreased after heating in pure water,a new peak was found in HPLC spectra and supposed to be the derivate of aristolochic acid Ⅰ,which was also found in the decoction of Caulis Aristolochiae Manshuriensis.The content of aristolochic acid Ⅰ in the concoction of Cortex Moutan with Caulis Aristolochiae Manshuriensis is lower than that in the single Caulis Aristolochiae Manshuriensis decoction.Furthermore,the quantity of aristolochic acid Ⅰ in the residues of Caulis Aristolochiae Manshuriensis after concoction is lower than that in the residues of single Caulis Aristolochiae Manshuriensis decoction.Conclusion Aristolochic acid Ⅰ is unstable in decoction and a part of it was changed into another compound.The stripping of aristolochic acid Ⅰfrom Caulis Aristolochiae Manshuriensis is not inhibited when Cortex Moutan concocted with Caulis Aristolochiae Manshuriensis.It is the chemical reaction of aristolochic acid Ⅰ,which could decrease the toxicity in the decoction or concoction of Caulis Aristolochiae Manshuriensis.

To study the effects of fentanyl on the MAC of sevoflurane. Method: One hundred and sixteen patients were given continuous infusion of fentanyl with CACI-pump (computer-assisted continuous infusion)to maintain different target plasma concentrations (Ct), meanwhile inhaled sevoflurane. All patients were randomly divided into seven groups receiving sevoflurane in oxygen with fentanyl target plasma concentration of 0?g/L (n=16), 0.5?g/L(n=20), 1?g/L(n=18), 2?g/L(n=16), 3?g/L(n=18), 4?g/L(n= 14) or 6?g/L(n= 14). Plasma concentraion of fentanyl was measured with radioimmunoassay. MAC determination, in response to the stimulus of skin incision, was made using the "up-down" method and logistic regression. Result: The MAC of sevoflurane from group 1 to group 7 were 1.94%, 1.89%, 1.55%, 1.29%, 1.09%, 0.86% and 0.35% respectively. Conclusion: We verify the MAC of sevoflurane, which is reduced by increasing plasma fentanyl concentration.

Objective To investigate the influence of liraglutide combined with metformin and simple metformin on insulin re‐sistance in the patients with type 2 diabetes mellitus(T2DM ) .Methods Thirty patients with T2DM treated by liraglutide combined with metformin were collected as the experimental group ,while other 30 patients with T2DM treated by single metformin were col‐lected as the control group .The changes of HbA1c ,HOMA‐IR ,adiponectin ,NO and ET before treatment and at 3 months after treatment were compared between the two groups .Results The decrease degree of HbA1c ,HOMA‐IR ,NO and ET and the in‐crease degree of adipodectin in the experimental group were more significant than those in the control group with statistical differ‐ences between the two groups(P<0 .05) .Conclusion Liraglutide has more significant effect than metformin for improving the in‐sulin resistance in the patients with T2DM .

Objective To investigate the assessment value of multimodal CT examination for collateral circulation after cerebral ischemia. Methods Within 3 days of admission,39 patients with ischemic stroke received multimodal CT examinations,including CT scan,CT perfusion (CTP)imaging,and CT angiography (CTA). The postprocessing software of the German SIEMENS 64-slice spiral CT system was used to evaluate the state of brain tissue perfusion and the conditions of head blood vessels of the subjects. The cerebral blood flow(CBF),cerebral blood volume(CBV),mean transit time(MTT),time to peak(TTP) and the score of the modified Rankin scale (mRS)in the 90 d after discharge were compared between the patients with good collateral circulation and poor collateral circulation. Results Among 39 patients, multimodal CT examination revealed that 2 patients were negative,one of them was followed up by head MR and was clinically proven as transient ischemic attack,and the other was lacunar infarction. Thirty-seven patients were positive. Multimodal CT examination found 24 patients had offending vessels occlusion and/or stenosis on the lesion sides,the collateral circulation formation in 11 of them was observed on the lesion sides;another 13 patients had poor collateral circulation on the lesion sides. The comparison of lesion sides and contralateral sides,the patients with good collateral circulation showed the CBF decreased (t= -5. 92),the MTT and TTP prolonged (t=4. 27 and 3. 17 respectively). There were significant differences (all P<0. 01). The CBV and CBF in patients with poor collateral circulation were decreased significantly (t= -14.27 and-14.82 respectively),MTT and TTP prolonged (t=7. 26 and 7. 54 respectively). There were significant differences (all P <0. 01). There were significant differences in CBF,CBV,and TTP on the lesion sides between the two groups of patients (t=3. 24,4. 11,and -2. 34,respectively;all P<0. 05). The 90 d mRS scores for patients with good collateral circulation and poor collateral circulation were 1. 3 ± 0.6 and 4. 0 ± 0. 9 respectively. There was significant difference (t = -8. 29,P <0. 01). The patients of having collateral circulation formation had good prognosis. Conclusion Multimodal CT examination has certain clinical significance for evaluation of cerebral perfusion state,understanding the establishment or patency of cerebral collateral circulation,and determining the clinical prognosis.

Objective To study the efficacy and safety of naftopidil,a new ? 1-adrenoceptor antagonist for treatment of benign prostatic hyperplasia(BPH). Methods A randomized,double-blind,double-simulant,parallel-controlled,multicentral clinical trial was conducted in 224 patients with BPH.Patients of treatment group received naftopidil (25 mg,once a day) and the controls received tamsulosin (0.2 mg,once a day). Results After 6-week therapy,IPSS,quality of life (QOL) score,maximum urinary flow rate (Qmax) and average urinary flow rate(Qave) were significantly improved both in naftopidil group and tamsulosin (control) group.In naftopidil group,IPSS was averagely decreased by 11.03 (P0.05).The clinical adverse event rate was 2.68% in naftopidil group, which was significantly lower than that in tamsulosin group (8.93%,P

Objective To study effect of etoricoxib on IL-1βand TNF-αin patients with gouty arthritis.Methods 86 patients with gouty arthritis from July 2014 to July 2016 in our hospital were selected, all patients were divided into study group and control group according to the treatment method with 43 cases in each group.The patients in the control group were treated with diclofenac sodium, the patients in the study group were treated with etoricoxib.The clinical symptoms, clinical treatment effects, VAS score, serum IL-1β, TNF-αlevels and adverse reactions were observed and compared between the two groups.Results The VAS score, the joint swelling score and the mobility limitation score of the study group were decreased than before treatment and significantly lower than those of the control group, the difference was statistically significant (P<0.05).The effective rate of the study group (95.35%) was significantly higher than that of the control group (79.07%), the difference was statistically significant(P<0.05).The levels of IL-1βand TNF-αin the two groups were significantly lower than before treatment and the levels of IL-1βand TNF-αin the study groups were significantly lower than those in the control group,the difference was statistically significant(P<0.05).The incidence of adverse reactions in the study group was lower than that in the control group, the difference was statistically significant(P<0.05).Conclusion The clinical efficacy of etoricoxib in treating patients with gouty arthritis is significant, which can effectively relieve the clinical symptoms, inhibit the expression of IL-1βand TNF-α, and the adverse reactions less.