Objective To investigate the clinical value of the procalcitonin (PCT)measurement in preventing the occurrence of the bacterial drug resistance and reducing the overuse of antibiotics.Methods 400 inpatients without thyroid dysfunction but with suspected bacterial infections in our hospital from June 2012 to April 2013 were screeded out.Under the patient′s informed consent and the allowable condition,the routine treatment group (200 cases )and the PCT guidance group(200 cases )were obtained. Then,the antibiotic use time,hospitalization duration and hospitalization expenses were retrospectively anlyzed in the two groups. Meanwhile,the PCT guidance group was dynamically monitored.Results The mean antibiotic therapeutic time in the PCT guidance group was shorter than that in the routine treatment group;the average hospitalization days had statistical difference between the two groups (P<0.001 );the antibiotic expenses accounted for 26.4% and 32.0% of the hospitalization medication costs,which also had statistically significant difference (P <0.001).The clinical pulmonary infection scores(CPIS)were not compared because of lacking microbiology indicators.During the dynamic monitoring,when PCT<0.10 ng/mL,the antibiotic use was stopped,when PCT≥0.25 ng/mL,the antibiotic use was restored,when PCT≥0.25 ng/mL or≥0.50 ng/mL for consecutive 3 d,adjusting the antibiotics,dose or administrating route obtained significantly therapeutic effect,which indicating that PCT could be used for the prognosis judgement of the disease.Conclusion The once measurement of serum PCT could guide for diagnosing and assessing the infection degree,while its continuous measurement could guide the antibiotic use and make the prognosis on the disease condition.

Objective:To discuss the bacteria detection before and after disinfection by using central negative pressure suction device terminal socket, reduce cross infection probability in hospitals and provide evidence for disinfection management specification. Methods:one hundred and thirty clinical central terminal devices with negative pressure were disinfected spirally with iodine swabs and among them, Department of respiration 48, Department of cerebral surgery 46, and Pediatrics 36, were sampled and sent to be cultured by clinical laboratory personnel before and after disinfection. The specimens were administered in a sterile blood AGAR plate culture medium, and the bacterial growth conditions were observed to detect the bacteria number as pollution standards. Results: The pollution rates of clinical equipment central pressure suction into the terminal socket after disinfection were: Department of respiration 8.33%; Department of cerebral surgery 6.52%; Pediatrics 5.56%, and the average pollution rate was 7.69%.The detected cases of pathogenic bacteria were gram-negative bacteria pollution, and contrasting the pollution rates before and after disinfection was statistically significant(x2=14.08, P<0.05). Conclusion: Using based iodine swabs disinfection central pressure suction mouth terminal socket can reduce the cross infection between the patients with risk and provide patients with safe medical environment.

The 55th ASH annual meeting hold special education sessions and oral and poster presentations focused on Hodgkin lymphoma (HL).Experts from world around made highly of the monoclonal antibody to CD30 (BV),for it' s effectiveness on refractory or relapsed HL.The targeted chemotherapy which integrated BV with standard chemotherapy appeared promising as first line therapy in a few centers.The applications of other molecular inhibitors,anti-CD20 antibody and involved field radiation therapy had been discussed.A broad presentations and discussions had been made on HL of the gene expression profiling,molecular susceptibilities,the long non-coding RNA,the miRNA,the molecular diagnosis with peripheral blood,as well as prognosis related factors.

In non-small cell lung cancer( NSCLC),a major characteristic is the abnormal methylation of some certain genes. The hypomethylation of proto-oncogene has the potential to promote carcinogenesis and the formation of neoplasm may also be induced by the hypermethylation of tumor suppressor genes. Meanwhile, the balance between histone acetylation and deacetylation is closely connected to the tumorigenesis. While the histone acetyltransferases can directly acetylate genes related to proliferation,causing cell growth and transfor-mation,histone deacetylase will also alter the level of acetylation of certain proteins,and eventually affect NSCLC. Hence,these abnormal epigenetic modifications play a fundamental role in the formation and develop-ment of NSCLC.

Objective To compare the effect of Q-switch Nd ∶ YAG laser and intensive pulsed light on freckles.Methods 80 patients with freckles were divided into 2 groups randomly.One group of patients were treated with Q-switch Nd ∶ YAG 532 nm frequency-doubled laser,the interval was 8 weeks.The other group of patients were treated with 570 nm intensive pulsed light,the interval was 8 weeks.Results We used Mann-Whitney U test to compare the curative effect of the two groups (P ＜0.05),and the mean rank (34.00) of the Q-switch Nd;YAG laser treatment group was greater than that (47.00) of the intense pulsed light treatment group.Conclusions The curative effect of Q-switch Nd ∶ YAG laser is better than that of intensive pulsed light on freckles.

Nucleotide excision repair (NER) pathway is one of the principal ways of the repair of DNA damage.The single nucleotide polymorphisms (SNP) of its key genes such as xeroderma pigmentosum group A (XPA) gene,excision repair cross complementingl (ERCC1) gene and xeroderma pigmentosum group D (XPD) gene may be associated with differences in the DNA repair capacity and may influence an individual's risk of lung cancer,because the variant genotype in those polymorphisms might destroy or alter repair function.

Objective: To develop a classification tree algorithm to improve diagnostic performances of 99mTc-MIBI SPECT/CT fusion imaging in differentiating solitary pulmonary nodules (SPNs). Methods: Forty-four SPNs, including 30 malignant cases and 14 benign ones that were eventually pathologically identified, were included in this prospective study. All patients received 99Tcm-MIBI SPECT/CT scanning at an early stage and a delayed stage before operation. Thirty predictor variables, including 11 clinical variables, 4 variables of emission and 15 variables of transmission information from SPECT/CT scanning, were analyzed independently by the classification tree algorithm and radiological residents. Diagnostic rules were demonstrated in tree-topology, and diagnostic performances were compared with Area under Curve (AUC) of Receiver Operating Characteristic Curve (ROC). Results: A classification decision tree with lowest relative cost of 0.340 was developed for 99Tcm-MIBI SPECT/CT scanning in which the value of Target/Normal region of 99Tcm-MIBI uptake in the delayed stage and in the early stage, age, cough and specula sign were five most important contributors. The sensitivity and specificity were 93.33% and 78.57%, respectively, a little higher than those of the expert. The sensitivity and specificity by residents of Grade one were 76.67% and 28.57%, respectively, and AUC of CART and expert was 0.886±0.055 and 0.829±0.062, respectively, and the corresponding AUC of residents was 0.566±0.092. Comparisons of AUCs suggest that performance of CART was similar to that of expert (P = 0.204), but greater than that of residents (P<0.001). Conclusion: Our data mining technique using classification decision tree has a much higher accuracy than residents. It suggests that the application of this algorithm will significantly improve the diagnostic performance of residents.

Objective: To develop a classification tree algorithm to improve diagnostic performances of 99mTc-MIBI SPECT/CT fusion imaging in differentiating solitary pulmonary nodules (SPNs). Methods: Forty-four SPNs, including 30 malignant cases and 14 benign ones that were eventually pathologically identified, were included in this prospective study. All patients received 99Tcm-MIBI SPECT/CT scanning at an early stage and a delayed stage before operation. Thirty predictor variables, including 11 clinical variables, 4 variables of emission and 15 variables of transmission information from SPECT/CT scanning, were analyzed independently by the classification tree algorithm and radiological residents. Diagnostic rules were demonstrated in tree-topology, and diagnostic performances were compared with Area under Curve (AUC) of Receiver Operating Characteristic Curve (ROC). Results: A classification decision tree with lowest relative cost of 0.340 was developed for 99Tcm-MIBI SPECT/CT scanning in which the value of Target/Normal region of 99Tcm-MIBI uptake in the delayed stage and in the early stage, age, cough and specula sign were five most important contributors. The sensitivity and specificity were 93.33% and 78.57%, respectively, a little higher than those of the expert. The sensitivity and specificity by residents of Grade one were 76.67% and 28.57%, respectively, and AUC of CART and expert was 0.886±0.055 and 0.829±0.062, respectively, and the corresponding AUC of residents was 0.566±0.092. Comparisons of AUCs suggest that performance of CART was similar to that of expert (P = 0.204), but greater than that of residents (P<0.001). Conclusion: Our data mining technique using classification decision tree has a much higher accuracy than residents. It suggests that the application of this algorithm will significantly improve the diagnostic performance of residents.

Objective:To observe the sedation effects of midazolam on maxillofacial postoperative patients with nasotracheal intubation. Methods:40 cases were equally and randomly divided into two groups: sufentanil group (group S) and sufentanil-midazolam group(group S-M).The continuous dose was 2 ml/h. If the patients feel uncomfortable, patient controlled intravenous analgesia (PCIA) was used. To observe the changes of circulation and respiration,the changes of visual analogue scale(VAS) and Ramsay score, the patients' bucking times within 24 h and the PCIA times, patients' total satisfactory degree and the complications during postoperative analgesia were recorded. Results:There were significant decreases in VAS of two groups after postoperative analgesia 1, 4, 12, 24, 48 hours(P

Targeted therapy combined with chemotherapy has achieved great success in palliative treatment for metastatic colorectal cancer.Recent studies gave more emphasis on new fields,such as maintenance treatment,adjuvant treatment and the prognostic & predictive biomarker.These advances have been gradually changing the treatment strategies for colorectal cancer.The latest advances on the targeted therapy for colorectal cancer from the 2010 Annual Meeting of American Society of Clinical Oncology are reviewed below.