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.

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.

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 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.

Objectives To evaluate bioMerieux VIDAS(Vitek Immune Diagnositc Assay System) Chlamydia test (CHL) and to determine its performance(sensitivity and specificity) by comparing with cell culture. Methods C. trachomatis in urogenital samples was detected by both cell culture and VIDAS CHL. The different results were confirmed by direct fluorescent antibody assay (DFA). The sensitivity to C.trachomatis serotype D and E stocks was alsode tected with VIDAS CHL and cell culture. Results C.trachomatis was found in 33 (20.2%) of 163 urogenital samples by cell culture in coutrast to in 44(27.0%) by VIDA CHL. As the expanded gold standard was defined as either cell culture positive or cell culture negative and both CHL and DFA positive, the sensitivity was 80.5% and 95.3% and the specifiaty were 100% and 97.6% in cell culture and VIDAS CHL, respectively. In the sensitivity test, C. trachomatis serotype D was tested positive at the highest dilution of one to 102 400 dilution and serotype E was at one in 51 200 by cell culture. However, both serotype D and E were tested positive at the highest dilution of one to 6 553 600 by VIDAS CHL. Conclusions Comparing with the expanded gold standard, VIDAS CHL is sensitive and specific for C.trachomatis in urogenital specimens, with simple and short running hours (1 h). First catch urine (FCU), which avoids the painful male swab collectionin male patients, could also be used as specimen in VIDAS CHL test.

A high performance liquid chromatography-tandem mass spectrometric method ( HPLC-MS/MS ) was developed for the simultaneous determination of 31 kinds of triazine herbicides in farmland soils. Samples were extracted by accelerated solvent extraction ( ASE ) and purified by Oasis MCX solid phase extraction ( SPE) cartridges, and then analyzed by HPLC-MS/MS in multiple reaction monitoring ( MRM) mode with positive electrospray ionization. The analytical column was Phenomenex Luna C18 ( 150 mm í 2. 0 mm í3 μm) and the mobile phases were acetonitrile and water containing 0. 1% (V/V) formic acid. The limits of detection (S/N≥3) were 0. 008-0. 440 μg/L. All of the triazine herbicides had good linear responses with r≥0 . 996 and the average recoveries in the spiked levels of 0 . 40-40 . 0 μg/kg ranged from 76 . 9%-102 . 0%with the RSDs of 3 . 4%-10 . 3%. The HPLC-MS/MS method had been applied for the detection of the triazine herbicide residues in farmland soils from Shenyang region and the results showed that atrazine, simazine, prometryne and atrazine-desethyl were the main triazine herbicides in the region.

Objective To explore the teaching effects of the case study method in the comprehensive and designing experiments. Methods During the teaching process of the "Nursing Fundamentals", we organized students by groups to select medical samples, prepare and carry out experiment plans, as well as held sessions of experiment results reporting and teachers' comments. Results The experimental teaching plans designed by students covered the knowledge from 8 courses and 16 basic nursing operations. Teachers and students were all considering that the application of the case study method into the comprehensive and designing experiments of the "Nursing Fundamentals" had demonstrated the integration of both the teaching contents and the combination of knowledge, capability and quality. The exploration of students' creative thinking was paid attention to, their researching spirit when learning was also cultivated, the sense of professionalism and the awareness of "people-oriented ' nursing were strengthened, and the communication skills and adaptive capabilities were also trained. The teaching atmosphere was obviously activated, and the teaching effects were obviously improved. Conclusions The application of the case study method into the comprehensive and designing experiments enabled the students to well digest and completely understand knowledge from various subjects, as well as enhanced their capabilities of resolving practical problems, and it is also helpful to cultivate the overall quality of the nursing profession.

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.