Objective To explore application value of combined detection of procalcitonin(PCT ) and high‐sensitivity C‐reactive protein (hs‐CRP) in clinical diagnosis of infectious diseases .Methods 162 cases of hospitalized patients with infectious diseases from June 2012 to December 2014 were enrolled in this study and divided into bacterial infection group(92 cases)and viral infection group (70 cases) according to the results of isolation and culture of pathogen and virus antibody detection .Other 100 cases of healthy individuals were selected as healthy control .The serum levels of PCT and hs‐CRP were detected by using immunochroma‐tography and immunofluorescence assay respectively and were statistically analysed .Results The serum levels of PCT and hs‐CRP in the bacterial infection group were higher than those in the healthy control group ,the differences were statistically significant (P<0 .05) .The serum levels of PCT and hs‐CRP in the viral infection group were higher than those in the healthy control group , but only the difference of hs‐CRP between the two groups was statistically significant(P<0 .05) .In patients with bacterial infection and viral infection ,the positive rates of combined detection of hs‐CRP and PCT were higher than single detection of hs‐CRP or PCT ,the differences were statistically significant(P<0 .05) .Conclusion PCT and hs‐CRP could be important serum markers of bacterial infections ,combined detection of the two markers have clinical significance for diagnosing infectious diseases and assessing its prognosis .

OBJECTIVE:To provide reference for implementing relevant policies and measures,and promote rational drug use. METHODS:The cognition(questionnaire)and application(prescription spot checks)about antibiotics and glucocorticoids by 191 rural doctors from 14 township hospitals and 18 health room in area A,B and C(representing the economically developed areas, moderately developed areas and undeveloped areas)were investigated,and the results were statistically analyzed. RESULTS:Total-ly 382 questionnaires were sent out(191 for antibiotics and 191 for glucocorticoids),and 382 were effectively received with effec-tive recovery of 100%;and 2 300 prescriptions were checked. Results of questionnaire showed,there were still some misunder-standings and blindness among the rural doctors'cognition and application about antibiotics and glucocorticoids,the usage of β-lac-tam was not fully grasped,part of the empirical use of antibiotics and drug treatment was still not entirely clear,more than 40%had no clear ideas about the classification and contraindications of hormones,and more than half of them didn't know the Glucocor-ticoids Clinical Practice Guidelines;results of prescription spot checks showed,there were regional differences about the proportion of antibiotics and glucocorticoids,area A had the highest proportion among 3 areas,accounting for 60.9% and 18.9%,respective-ly. And area C showed highest proportion about unreasonable prescriptions,accounting for 22.5%. CONCLUSIONS:The cognition and reasonable use of rural doctors for antibiotics and glucocorticoids still needs to be strengthened. It is suggested to take effective measures,formulate and implement the corresponding supervision system,strengthen antibiotics and glucocorticoids knowledge training for rural doctors and fully implement the the principles of rational drug use to improve the rational drug use.

OBJECTIVE:To provide reference for clinical use and revision of drug instruction manual. METHODS:The ambi-guity in drug instructions manual was summarized and countermeasures of revision were presented based on the practical clinical conditions. RESULTS & CONCLUSIONS:The problems of drug instruction manual that may mislead the patients and medical per-sonnel were as follows as controversial main contents,unclear descriptions of instruction,unfocused contents or without key points,one instruction for multiple drugs,obvious or inaccurate translations,words without popularity and standardization and wrong sentence division or non-standard typesetting. It is suggested that the manufacturers should attach highly importance to the re-vision of drug instruction manual;the revisers should understand the meaning of drugs instruction manual and know the subjects;the premarketing instructions should be tested and investigated by necessary persons;the major and cultural quality of revisers should be improved;the approval monitoring should be strengthened and the feedback mechanism should be established to further improve the instructions,guide the medical staff and patients with accurate use of drugs and ensure the safe drug use of patients.

Objective:This study evaluates the relationship between carcino-embryonic antigen (CEA) and carbohydrate antigen 153 (CA153) continuous and remarkable reduction after chemotherapy and no-imaging progression in patients with advanced breast can-cer. Methods: Medical records of 93 patients who received chemotherapy in the Oncology Department of the General Hospital of Shenyang Military Command were included in the retrospective analysis. A total of 188 CEA and CA153 serum data were collected from response evaluations that included 105 CEA cases and 139 CA153 cases. Predictive validity of serum CEA and CA153 was as-sessed for diagnosing no-imaging progression. Results:CEA was continuously reduced by 10%, with sensitivity of 54.1%and specificity of 95%. CA153 was continuously reduced by 40%, with sensitivity of 19.1%and specificity of 96.6%. Conclusion:Serum CEA and CA153 could be considered as response evaluation tools when they are continuously reduced by at least 10%and 40%, respectively.

Objective To evaluate the efficacy of hypofractionated 3DCRT for primary liver cancer(PLC) with portal vein tumor thrombosis(PVTT).Methods Between April 1999 and August 2003,34 PLC patients with PVTT received hypofractionated 3DCRT.The severity of hepatic cirrhosis was 23 in Child-Pugh gradeA and 11 gradeB.The median value of GTV was 773?cm~3(105-2097?cm~3).The radiotherapy regimen consisted of 38-63?Gy in 7-15 fractions with 4-8?Gy per fraction(median value 5?Gy),the treatment was delivered 3 times per week during every other day.Results Having response rate(CR+PR) of 76%(26/34),the overall 1-,2-,and 3-year survival rate at was 36%,19% and 13%,respectively.Conclusion Hypofractionated three-dimensional conformal radiotherapy is effective for primary liver cancer with portal vein tumor thrombosis.

Objective:To investigate the cognitive characteristics,dangerous factors and the syndromes in mild cognitive impairment(MCI).Methods: Memory and cognitive function were assessed with Mini-Mental State Examination(MMSE).The MCI cases and normal controls were assessed by the Delayed Paragraph Story Recall Examination(DPR).A syndrome scale was used to diagnose the syndromes of subjects.The diagnosis of MCI,AD was made according to Petersen’s criteria,NINCDS-ADRDA,respectively.Results: MMSE scores of MCI cases were higher than that of normal controls,a signifi cantly difference was found.Average education level of normal controls was higher than that of MCI cases,but average contractive pressure was lower.Defi ciency of kidney,defi ciency of qi and phlegm syndromes were popular in both MCI cases aormal controls,and MCI cases had increased percentage of combined syndromes.Conclusion:The cognition function of MCI cases was decreased.Cognitive impairment was related to hypertensive disease and low education.As the development of cognitive impairment,complex Chinese medical syndromes appeared.

Objective To explore the relationship between lumbar disc degeneration (LDD) of lumbar spinal stenosis(LSS)and the dural sac cross-sectional area(DSCA)by MRI measurement. Methods 91 patients with central degenerative LSS were randomly selected and 91 age-and sex-matched people without LSS were select-ed as a control group. LDD was classified into five grades by MRI detection according to the method proposed by Pfirrmann and DSCA were measured. Results LDD was not associated with age in LSS. The proportion of severe degenerated disc in lower lumbar levels were higher than that of L2/3 in the two groups;DSCA in severe degenerat-ed disc group was significantly smaller than that in light degenerated group only in L2/3 and L3/4 in LSS. There were no statistical differences in every lumbar level in the control group. Conclusions LDD in L4/5 and L5/S1 of LSS is more severe than that of the normal people. DSCA and LDD are positively correlated in L2/3 and L3/4,but not in L4/5 and L5/S1 for LSS.

10.3969/j.issn.1000-8179.2013.12.010

Objective To investigate the development status of tumor radiotherapy in Guangxi Zhuang autonomous region in order to provide reference for the decision-making of the competent administrative departments for public health.Methods A questionnaire survey was conducted by the aid of on-site inspection and telephone or Email investigation among the medical institutions in Guangxi to know the current status of radiotherapy units and settings,human resources,allocation of radiotherapy facilities,and standardization of medical practices.Results Up to the end of August 2014,radiotherapy was carried out in 39 hospitals,with other 5 hospitals under preparation for construction.Among these 40 hospitals were three-dimensional conformal radiotherapy in 38,intensity modulated radiation therapy (IMRT) in 23,and image guided radiation therapy (IGRT) in 5.There were 48 linear accelerators,15 afterloading therapy apparatus,and 4 γ-knife or X-knife in Guangxi.There were 647 professional personnel (except nurses),including 322 radiation oncologists,100 radiotherapy physicists,213 radiotherapy technologists and 12 professional engineers.There were 2 000 to 2 500 hospital beds and 20 000 cancer patients had received radiotherapy in 2013.1 600 to 2 000 people received treatment on average every day.Conclusions The present radiotherapy resources in Guangxi are insufficient and the input to radiotherapy equipment is deficient,with low proportion of cancer patients treated with radiotherapy.Because of the uneven radiotherapy quality among different hospitals,the reasonable planned development and unified diagnostic and treatment practices are required to improve radiotherapy level in Guangxi.For shortage of medical staff and high-quality physical and technical personnel,the improvements are needed by fostering and introduction of personnel.Compared with developed regions in China,the introduction of new technology is largely needed.

Objective To explore the prognosis and related factors of brain glioma .Methods 133 patients who have been con-firmed pathology with brain glioma from Jan .2001 to Dec .2010 were retrospectively analyzed .The factors such as sex ,age ,func-tional status ,histological character ,the longest diameter of tumor ,surgical excision of part or all of the tumor ,whether or not being radiotherapy after surgical excision were selected to evaluate by single factor and multiple factors analysis .Results The median fol-low-up time was 36 months ,The follow-up rate was 93% .73 cases were followed up for 3 years ,the 1- ,2- and 3- year survival rate was 93% ,82% and 70% ,respectively ,the median survival time was 62 .7 months .Multiple factors regression analysis showed that histological character ,the longest diameter of tumor and whether or not being radiotherapy after surgical excision were related to prognosis .Conclusion High-grade of histological character ,the longest diameter of tumor≥6 cm predict poor prognosis ,postop-erative radiotherapy can improve the survival of glioma .