0.05). Conclusion The improved puncture drainage of lateral ventricle for treating tuberculous meningitis was better than the traditional one, and was worthy of popularization.

Objective To analyze the relative factors of bone marrow suppression after chemotherapy with different-dose carboplatin and paclitaxel (TC) on the patients with ovarian cancer.Methods Sixty-two patients with ovarian cancer admitted in Beijing Obstetrics and Gynecology Hospital from January 2002 to December 2007, using TC regimen ,a total of 196 cycles of chemotherapy ,were divided into two groups by the doses of carboplatin [area under concentration-time curve(AUC) 4 -6 for low-dose,AUC >6 -7 for hight-dose, the carboplatin dose calculated with AUC] or by the doses of paclitaxel (135 -< 150 mg/m2 low-dose,150 - 175 mg/m2 hight-dose). After each TC cycle, the routine blood was test to determine the graduation of the marrow suppression, and then the correlation factors were analyzed with logistic regression. Results (1) The occurrence rate of bone marrow suppression:there were 159 cycles (81.1%) grade 0 - Ⅱ bone marrow suppression, while 37 cycles (18.9%) of grade Ⅲ - Ⅳ. (2) Factors related to bone marrow suppression:the results shown that there were not related to bone marrow suppression,which incluced cellular differentiation, tumor type, height, weight and paclitaxel dose(P>0.05). While,the different cycle, age, the later stages of tumor, serum creatinine concentration, endogenous creatinine clearance rate, AUC values were the relative factors of bone marrow suppression(P =0.000,0.000,0.018,0.033,0.001,0.000). Seven variables were conducted into the logistic regression and the results shown that the different cycles, the age, AUC grades were independent risk factors (P = 0.030,0.043,0.009).(3) When low-dose of paclitaxel was given, the occurrence of bone marrow suppression was related to the carboplatin dose AUC. The higher AUC values for carbopaltin were chosen, the higher of severe bone marrow suppression would happen. (4/14 vs 0,P=0.015). When the dose of high grade of paclitaxel was given, the occurrence of bone marrow suppression in cases with hight-dose carboplatin was statistically significant than that in cases treated with low-dose carboplatin [45.7%(16/35) vs 13.7% (17/124), P=0.000]. Conclusions The independent risk factors of myelosuppression after chemotherapy with TC regime on the patients with ovarian cancer including the cycles, age and AUC values. The carboplatin dose calculating with AUC is related to the occurrence of bone marrow suppression, the higher AUC values for carbopaltin would chosen,the higher of severe bone marrow suppression would be happen.

Objective To analyze the changes in platelet parameters and their influential factors in cirrhotic patients with hepatocellular car-cinoma (HCC).Methods The clinical data of 602 cirrhotic patients with HCC who were admitted to the First Hospital of Jilin University from January 201 1 to December 2012,as well as 200 cirrhotic patients hospitalized during the same period,were collected.Statistical analy-sis was performed using SPSS 19.0.Normally distributed continuous data were expressed as mean ± standard deviation;comparison be-tween two groups was made by t test,and comparison between multiple groups was made by analysis of variance.Non-normally distributed data were expressed as median and interquartile range (P25 -P75 );comparison between groups was made by rank sum test.Results Com-pared with the cirrhotic group,the HCC group had significantly higher platelet count (PLT)and plateletcrit (PCT)(t=5.019,P=0.000;t=5.017,P=0.000)and a significantly lower mean platelet volume (MPV)/PLT (t=5.877,P=0.000);there were no significant differences in MPV and platelet distribution width between the two groups (t=-0.942,P=0.347;t=-1.040,P=0.298).The receiv-er operating characteristic (ROC)analysis showed that the area under the ROC curve was 0.636 for PLT,0.633 for PCT,and 0.639 for MPV/PLT in the diagnosis of HCC in cirrhotic patients.Decreases in PLT and PCT were closely related to hepatitis C virus (HCV)infec-tion.Patients with Child-Pugh class A cirrhosis had significantly higher PLT and PCT than those with Child-Pugh class B and C cirrhosis (P<0.01);patients with a maximum tumor diameter of≥5 cm had significantly higher PLT and PCT than those with maximum tumor di-ameters of2-5 cm and≤2 cm (P<0.01).Patients with Child-Pugh class A cirrhosis had a significantly lower MPV/PLT than those with Child-Pugh class B and C cirrhosis (P<0.01);patients with a maximum tumor diameter of≥5 cm had a significantly lower MPV/PLT than those with maximum tumor diameters of2-5 cm and≤2 cm (P<0.01).Conclusion PLT,PCT,and MPV/PLT can be used in the auxiliary diagnosis of HCC in cirrhotic patients,which are related to HCV,Child-Pugh classification,and tumor size.

Objective To investigate the levels and clinical significance of serum 25 -hydroxy vitamin D[25 (OH)D]in patients with chronic liver disease.Methods A total of 153 hospitalized patients with chronic liver disease in the First Affiliated Hospital of Jilin Univer-sity from June 2012 to September 2013 were enrolled in the study group.The levels of serum 25(OH)D were measured by liquid chromatog-raphy tandem mass spectrometry.The serum samples from 300 healthy volunteers who underwent physical examination in our hospital were used as controls.The study group was divided into three subgroups:non -cirrhosis,liver cirrhosis [Child -Pugh (CP)grades A,B,and C],and primary biliary cirrhosis.Comparison of continuous data between groups was made by t test and analysis of variance,and compari-son of categorical data was made by chi -square test.Correlation between different variables was investigated by Pearson linear regression a-nalysis.Results Of the 153 patients with chronic liver disease,the percentages of those who had vitamin D adequacy (≥30 ng/ml),in-sufficiency (20 -30 ng/ml),deficiency (10 -20 ng/ml),and severe deficiency (<10 ng/ml)were 20.3%,22.9%,35.9%,and 20.9%,respectively.The percentages of patients with vitamin D deficiency and severe deficiency were significantly higher in the cirrhosis subgroup than in the non -cirrhosis and primary biliary cirrhosis subgroups (41.7%,25.0% vs 27.5%,12.5% and 23.5%,17.6%,re-spectively;χ2 =6.261 -18.474,P =0.001 -0.012).The serum 25(OH)D levels in patients with cirrhosis were significantly lower com-pared with those in patients without cirrhosis and in controls (18.58 ±12.48 vs 23.78 ±11.81 and 25.69 ±12.39 ng/ml,P =0.029 and 0.001).CP class C cirrhotic patients had significantly lower serum levels of 25(OH)D compared with CP class A patients (P =0.009). Conclusion Serum 25(OH)D deficiency is common in patients with chronic liver disease.25(OH)D levels in cirrhotic patients,especial-ly in CP class C patients,are markedly lower than those in non -cirrhotic patients.

Objective To compare image quality and radiation dose of the new imaging plate (IP) with the used IP on computed radiography (CR),and to investigate the using principle in the two kinds of IP. Methods The dark noise, uniformity and erasure thoroughness of the new and the used IP were measured respectively.Based on threshold contrast-detail detectability(TCCD) technique,the phantom T0.16 photography was done at 75 kV,and with the two kinds of IP respectively.Three observers scored each image sequence using double blind method,calculated the threshold detection index (HT).The volunteers were randomly divided into three groups:the knee joint group,the chest group and the lumbar group.Each group had 50 cases and checked with the same condition as the phantom.Three radiologists using double blind method evaluated the imaging quality of knee joint,chest and lumbar.Results The physical characteristic indexes of the new and the used IP were similar to each other.Under the same condition,the detection ability of the new IP was better than that of the used one.When the dose of exposure was raised about 20%,the detection ability of the used IP was close to that of the new one.Conclusions The dose of exposure can be raised to keep the same imaging quality with the increase times of IP used.The detection ability of IP can decrease with the same dose as before,and the image quality decreases too.

AIM: To explore the immunotheraptical drugs for multi-drug resistant pulmonary tuberculosis (MDR-TB). METHODS: 79 patients with MDR-TB were randomly assigned to two groups. 46 cases in M.vaccae group were treated with "3AkPaThLevL/15PaThLevL" and M. vaccae, and 33 cases in control group were treated only with "3AkPaThLevL/15PaThLevL". The clinical effect and T-lymphocyte subsets in patients were observed after being treated for 1,2 and 3 months, respectively. RESULTS: The sputum negative rates ((41.3)%, (63.0)%, and (80.4)%) and the X-ray resolution rates ((30.4)%, (50.0)%, and (67.4)%) of the M.vaccae group were superior to those ((12.1)%, (27.3)%, and (39.4)%, P

Objective To study the effect of magnetic field on serum activity of superoxide dismutase (SOD), content of malon-dialdehyde (MDA)and content of nitric oxide (NO)in patients undergoing operation for pituitary Tumor. Methods Sixteen ASA Ⅰor Ⅱ patients undergoing pituitary tumor surgery under general anesthesia were randomly divided into 2 groups (n=8 each): magnetic field group (M) and control group (C). Patients in magnetic field group were exposed in 150 mT magnetic field during the operation period.Blood samples were taken from radial artery for determination of serum SOD,MAD and NO before induction of anesthesia(T_0, baseline),after induction(T_1),70 min after induction(exposed in magnetic field for 60 min) (T_2)and 130 min after induction (exposed in magnetic field for 120 min) (T_3). Results There was no significant difference between the two groups in age, sex (M/F ratio),body weight,body height,duration of operation and duration of anaesthesia.The serum activity of SOD and content of NO were significantly higher at T_3 in group M than that in group C,and the serum content of MDA was lower at T_3 in group M than that in group C. Conclusions The magnetic field not only increases serum SOD activity and the content of NO in patient undergoing operation for pituitary tumor,but also reduces the content of MDA in them.

Objective To investigate the clinical features of capillary leakage syndrome ( CLS ) occurring in critically ill newborns in Guangzhou. Methods Three tertiary hospitals in Guangzhou were chosen as research field;critically ill newborns with diagnosis as CLS in NICU of three hospitals were retro-spectively studied from January 2011 to December 2015; and the morbidity,mortality,causes,treatment and outcome of CLS neonates were analyzed. Results There were 49 cases diagnosed as CLS, accounting for 1. 62%(49/3 029)of the total number of critically ill newborns admitted to NICUs in the same period. The common primary factors were preterm low birth weight(34 cases,69. 4%),respiratory distress syndrome(38 cases,77. 5%),congenital anomaly(19 cases,38. 8%),asphyxia(17 cases,34. 7%),and intrauterine infec-tion(12 cases,24. 5%). The 83. 7%(41/49) of CLS occurred within 72 hours after admission. The overall mortality of CLS was 30. 6%( 15/49 ) . The main lethal cause was multiple organ dysfunction syndrome (60. 0%,9/15). Treatment included antibiotics,vasoactive drugs,fluid resuscitation,corticosteroids,and me-chanical ventilation. Conclusion CLS is a common critical illness in NICU with high mortality and poor prognosis. Early prediction and early intervention could improve survival and prognosis in critically ill neonates with CLS.

Objective To summarize the clinical features of pancreatic injury in children,and to explore the suitable methods for its diagnosis and treatment.Methods A retrospective analysis of children with pancreatic injury within the 15 years was carried out.Clinical injury severity and following-up data were collected.Correlationship between injury severity,treatment method and successful rate was analyzed.Results Eleven children aged 4 to 14 years old were diagnosed as pancreatic injury:two had GradeⅠinjury,three GradeⅡ,five GradeⅢ,and one GradeⅣ.CT scan was used in 7 children,and 5 had positive sign.Patients with GradeⅠand GradeⅡinjuries were successfully cured without surgery.Three children with GradeⅢinjury were initially treated without operation,but two developed a large symptomatic pseudocyst and were cared through operation,and another one died.The other two children with GradeⅢwho underwent a distal pancreatectomy cured without complications.A patient with GradeⅣinjury was treated by Berne operation and died. Conclusion The management of pancreatic injury in children should be individualized depending on diagnosis time and injury type.A repetitive CT scan was helpful within 24h after injury.Distal pancreatectomy was a safe and effective for those with GradeⅢinjury.

0.05), the IFN ?R1 in advanced cases without splenectomy was low ( P