Objective To investigate the guidance value of procalcitonin(PCT) dynamic measurement on antibiotics usage of patients with stroke associated pneumonia(SAP).Methods One hundred and thirty-two cases with SAP were randomly divided into control group(64 cases with regular treatment) and observation group (68 cases with procalcitonin dynamic monitoring treatment).The treatment course of antibiotics in control group was according to antibiotics guidelines in China.Patients in observation group were given antibiotics for 5 days,stopped if the level of PCT was less than 0.25 μg/L,and continued to take if the level of PCT was more than 0.25 μg/L.The information were recorded including periods and cost of antibiotics usage,the periods and costs of hospitalization,clinical efficacy,mortality on the 30th day.The score of Institutes of National Institutes of Health Stroke Scale (NIHSS) and Barthel index (BI) were measured.Results (1) There were no significant differences in terms of age,gender,hypertension rate,coronary heart disease rate,diabetes rate,systolic blood pressure,the score of NIHSS in admission,pathogen and antibiotics between two groups (P ＞ 0.05).(2) After 30 days treatment,there were no significant differences in terms of clinical efficacy(86.8％ (59/68) vs.87.5％(56/64)),mortality (7.4％ (5/68) vs.7.8％ (5/64)),the score of NIHSS ((12.3 ±5.8) vs.(11.7 ± 4.5)) and BI (60.9 ± 22.3 vs 58.7 ± 21.6) between observation group and control group (P ＞ 0.05).The periods of hospitalization in observation group was (20.1 ± 5.1) d,less than that of control group ((25.4± 6.0) d,t =5.479,P ＜ 0.01).The costs of hospitalization in observation group was (8 ± 6) thousand yuan,significant lower than that of control group ((12 ± 8) thousand yuan,t =3.262,P ＜ 0.01).The periods of antibiotics usage in observation group was (11.3 ± 2.6) d,less than that of control group ((14.4 ± 3.1) d,t =6.238,P ＜ 0.01).The costs of antibiotics in observation group was (3 ± 1) thousand yuan,significant lower than that of control group ((5 ± 2) thousand yuan,t =7.331,P ＜ 0.01).Conclusion PCT dynamic monitoring can guide the safe usage of antibiotics in SAP in terms of shortening the length of hospitalization,duration of antibiotics,and reducing the costs.

Objective To investigate the clinical and genetic features of juvenile-onset Huntington disease (HD).Methods The clinical data of members from one juvenile-onset HD family,admitted to our hospital in February 2015,were collected,and the family pedigree tree was drawn.Peripheral venous blood of volunteers of this family was extracted to pursue IT15 genetic test.Results The pedigree tree indicated that HD was autosomal dominant inheritance.There were 3 patients in this family,2 of them died,and 2 were juvenile-onset HD.Clinical manifestations of these patients were characterized by dystonia,dysarthria,ataxia and cognitive dysfunction.Among 7 participants who pursued genetic test,4 were normal,and 3 carried expanded alleles,whose cytosine-adenine-guanine trinucleotide (CAG) repeat number was 59,60,and 57,respectively.Conclusions (1) The clinical manifestations of juvenile-onset HD are characterized by dystonia,dysarthria,ataxia and cognitive dysfunction;juvenile-onset HD has rapid progression.(2) The phenomenon called "anticipation" is found in this family.

Background: Red blood cell distribution width/platelet count ratio (RPR) is a reliable prognostic assessment indicator for numerous diseases. However, no studies to date have examined the relationship between RPR and the prognosis of diffuse large B-cell lymphoma (DLBCL).Therefore, this study aimed to investigate the correlation between RPR and the clinical characteristics and prognosis of patients with diffuse large B-cell lymphoma. Methods: We retrospectively studied 143 patients with newly diagnosed DLBCL and used the median value as the RPR threshold. We also investigated the correlation of pretreatment RPR level with clinical characteristics and its impact on DLBCL prognosis. Results: Using the median value as the cut-off, patients with DLBCL were divided into a low RPR group (＜0.0549) and a high RPR group (≥0.0549). Patients in the high RPR group were older, had a later Ann Arbor stage, were prone to bone marrow invasion, and had a higher National Comprehensive Cancer Network International Prognostic Index score (P ＜ 0.05). A survival analysis showed that progression-free survival (PFS) (P =0.003) and overall survival (OS) (P ＜0.0001) were significantly shorter in the high versus low RPR group. A multifactorial Cox analysis showed that bone marrow invasion and elevated lactate dehydrogenase (LDH) were separate risk factors for PFS (P ＜0.05), while an RPR ≥0.0549 and elevated LDH were separate risk factors for OS (P ＜0.05). Conclusion A high RPR (≥0.0549) in patients with newly diagnosed DLBCL is an independent risk factor for a poor prognosis.