It is very difficult to distinguish infectious lung diseases from no-infectious ones,and a correct practice guideline is of great significance.There are several important principals for physicians in dealing with the situation:collection of a detailed patients' history and physical examination information,objective evaluation of laboratory findings,an ability of imaging diagnosis and differential diagnosis,prompt invasive procedure with caution,and skillful empiric treatment.Different pathogens should be tested for infectious lung diseases.The non-infectious lung diseases should be handled with strong sense of caution,so as to avoid misdiagnosis and missed diagnosis.

Objective To explore the correlation of serum high -sensitivity C -reactive protein and ische-mic stroke in elderly people.Methods 120 patients with acute cerebral infarction were selected as the cerebral infarction group,100 healthy people taken examination at the same period were selected as the control group.The lev-els of serum high -sensitivity C -reactive protein in the two groups were detected,and the serum high -sensitivity C -reactive protein levels in patients with different cerebral areas and different neurological function scores were analyzed.Results Serum high -sensitivity C -reactive protein level in the cerebral infarction group was (10.17 ± 3.13)mg/L,which was significantly higher than that of the control group[(0.81 ±0.24)mg/L],the difference was statistically significant(t =29.82,P <0.05).And the serum high -sensitivity C -reactive protein level was gradually increased with cerebral infarct volume increased and the deepening of neurological deficits(P =0.01).Conclusion The serum high -sensitivity C -reactive protein level in elderly patients with ischemic stroke was higher than healthy people,the larger the infarct volume and the more severe neurological deficits,the higher sensitivity C -reactive protein levels,it is worthy of reference.

OBJECTIVE:To observe the efficacy and safety of Xingnaojing injection in the treatment of ischemic stroke. METH-ODS:110 patients with ischemic stroke were randomly divided into control group and observation group. 2 groups were given regu-lation of blood pressure and blood glucose,lipid lowering,aspirin,citicoline and edaravone,mannitol depending on severity and other conventional treatment. Based on it,control group was intravenously infused 250 ml 0.9% Sodium chloride injection,once a day;observation group was additionally intravenously infused 20 ml Xingnaojing injection,adding into 250 ml 0.9% Sodium chlo-ride injection,once a day. The efficacy was judged after 14 d. US National Institutes of Health Stroke Scale(NIHSS),Glasgow coma score(GCS),nitric oxide(NO),nitric oxide synthase(NOS),inducible nitric oxide(iNOS)content in 2 groups were ob-served,and in the incidence of adverse reactions was recorded. RESULTS:The total effective rat in observation group was signifi-cantly higher than control group,the difference was statistically significant(P<0.05). Before treatment,there were no significant differences in the NIHSS,NO,NOS and iNOS contents between 2 groups(P>0.05);after treatment,GCS in 2 groups were sig-nificantly higher than before,and observation group was higher than control group,NIHSS,NO,NOS and iNOS contents were significantly lower than before,and observation group was lower than control group,the differences were statistically significant (P<0.05). And there was no significant difference in the incidence of adverse reactions between 2 groups(P>0.05). CONCLU-SIONS:Based on conventional treatment,Xingnaojing injection has significant efficacy in the treatment of ischemic stroke,with good safety,which may be related that it can reduce NO and GCS.

Objective To explore the value of ultrasound on the early bone erosion of finger joint in patients with rheumatoid arthritis (RA).Methods Sixty-three cases of RA patients (patients group) with 486 finger joints was examined by high-frequency ultrasound,X-ray films and MRI,and compared with 20 controls (control group).Results The ultrasound results were significant difference between two groups (P＜0.01).The positive rate was 84.2％(409/486) in high-frequency ultrasound,and 56.2％(273/486) in X-ray films,there was significant difference between the two (P ＜ 0.05 ).The positive rate by high-frequency ultrasound was 63.8％ (136/213) in X-ray check-negative patients,and 68.1％ (145/213) by MRI.The results of the MRI contrast sensitivity of 97.6％,specificity of 75％,accuracy of 96.5％ by high-frequency ultrasound.Conclusion The high-frequency ultrasound on the X-ray check-negative patients with rheumatoid hand early joint bone erosion have some diagnostic value.

Objective:To investigate the effectiveness of digital multifunction trauma rinser(DMTR) in open wound irrigation.Method:Rabbits weighing 2~3kg were recruited to mimic wounds including superficial second degree scald,concis and avulsed wound,then contamination with Bacillus coli was followed.Irrigating using DMTR or dumping washing method was performed in 10 minutes.After the evaluation of the cleanness of the wounds,bacteria counts in wound were performed through smear method.Result:The effectiveness difference between DMTR and dumping washing method was statistically significant.Conclusion:DMTR is superior to dumping washing method in wound irrigation.It obviously removes germs,fragments and foreign bodies in wound with higher efficiency.It is convenient and worthy applying.

Objective:To investigate the effect of triptolide combined with dexamethasone on proliferation and apoptosis of the mycosis fungoides hut-102 cells and the possible mechanisms.Methods:The viability of hut-102 cells was measured by MTT assay;the apoptotic rate of hut-102 cells was detected by flow cytometry.The expression levels of Glucocorticoid receptor(GR)and apoptosis-related protein Caspase-3 were determined by Western blot analysis.Results:①MTT assays showed that different concentrations of triptolide or dexame thasone can effectively inhibit the proliferation of hut-102 cells in a dose and time-dependent manner.When triptolide(12.5 nmol/L)was co-administered with dexamethasone,the inhibition rate increased along with the concentration of dexamethasone.And we observed positive cooperative inhibitory effects of triptolide and dexamethasone on the proliferation of hut-102 cells.②Both triptolide and dexame thasone can independently promote apoptosis of the hut-102 cell.And the apoptotic rate in the combination group was higher than single group(P

Objective To investigate the effects of colloid preconditioning on hemodynamics of patients with laparoscopic colon surgery during pneumoperitoneum period.Methods Fifty patients withlaparoscopic colon surgery were divided into control group(group A,25 cases)and colloid preconditioning group(group B,25 cases)by random digits table.The mean arterial pressure(MAP),heart rate(HR),central venous pressure(CVP),cardiac index(CI),systemic vascular resistance index(SVRI),hemoglobin(Hb)and haematocrit(Hct)were recorded before anesthesia(T0),5 min after anesthesia(T1),5 min after pneumoperitoneum(T2),10 min after pneumoperitoneum(T3),15 min after pneumoperitoneum(T4)and 5min after pneumoperitoneum completely(T5).Results MAP in group A at T1-3[(68.7±5.3),(72.5±4.8),(73.1±6.3)mm Hg(1 mm Hg=0.133 kPa)]was significantly lower than that at T0[(81.7±6.1)mm Hg](P＜0.05).MAP in group B at T3,4[(93.2±5.8),(87.6±4.2)mm Hg]was significantly higher than that at T0[(80.2±5.6)mm Hg](P＜0.05).At T1,2,MAP in group A was significantly lower than that in group B[(79.8±5.4),(83.2±5.3)mm Hg](P＜0.05).CVP in group A at T2-4[(7.8±2.4),(8.1±2.2),(8.2±2.0)cm H2O(1 cm H2O=0.098 kPa)]was significantly higher than that at T0[(6.5±2.1)cm H2O](P＜0.05).CVP in group B at T1-4[(11.7±3.4),(13.5±3.6),(15.8±3.8),(16.6±3.7)cm H2O]was significantly higher than that at T0[(6.3±2.5)cm H2O](P＜0.05).There was significant differences in CVP at T1-4 between group A[group A at T1:(5.6±2.2)cm H2O]and group B(P＜0.05).CI in group A at T2-4[(2.6±0.2),(2.1±0.1),(2.7±0.3)L/(min·m2)]was significandy lower than that at T0[(3.5±0.4)L/(min·m2)](P＜0.05).CI in group B at T2-4[(3.1±0.3),(2.9±0.3),(3.0±0.4)L/(min·m2)]was significantly lower than that at T0[(3.6±0.5)L/(min·m2)](P＜0.05).There were significant differences in C I at T2-4 between two groups.SVRI in group A at T2-4[(2853±432),(2918±510),(2718±436)dynes·s/cm5]was significantly higher than that at T0[(2318±236)dynes·s/cm5](P＜0.05).SVRI in group B at T2-4[(2756±391),(2718±402),(2694±382)dynes·s/cm5]was significantly higher than that at T0[(2356±372)dynes·s/cm5](P＜0.05).There was no significant difference in HR between two groups(P＞0.05).Hb and Hct in group B at T1-4[(123.6±11.5),(125.6±9.5),(126.1±10.2),(128.6±11.4)g/L and 0.339±0.037,0.337±0.036,0.322±0.041,0.312±0.040]were significantly lower than that at T0[(134.7±12.2)g/L and 0.371±0.039](P＜0.05).There were significant differences in Hb and Hct at T1-4between group B and group A[(131.8±10.2),(130.7±12.8),(131.6±14.3),(133.5±12.3)g/L and 0.360±0.042,0.359±0.041,0.361±0.040,0.360±0.036](P＜0.05).There was no significant different in Hb and Hct of group A(P＞0.05).Conclusion Colloid preconditioning may effectively maintain the stability of circulation,reduce blood viscosity,and improve microcirculation during the pneumoperitoneum period.

Objective To evaluate the corneal astigmatism changes after phacoemulsification performed using clear corneal incision with different locations.Methods Seventy-two eyes of 72 patients having phacoemulsification and implantation of foldable intraocular lens through a clear corneal incision were chosen.Patients were divided into two groups by table of random digit:group A (incision at 11:00),group B (incision at the steepest corneal meridian).The change of corneal astigmatism was compared between group A and B postoperatively.Surgically-induced astigmatism (SIA) was calculated by vector analyses using the HoHaday-Cravy-Koch method.Results Preoperative corneal astigmatism between group A and group B had no significant difference [(0.96 ± 0.52) D vs.(0.94 ± 0.56) D,P ＞ 0.05].One and three months after operation,the corneal astigmatism in group A were significantly higher than those in group B [(1.15 ± 0.32)D vs.(0.82 ± 0.43) D,(0.85 ± 0.38) D vs.(0.63 ± 0.40) D,P＜ 0.05].The SIA in group A was significantly higher than that in group B 1 month after operation [(0.85 ± 0.37) D vs.(0.75 ± 0.54) D,P ＜ 0.05],there was no significant difference between group A and group B 3 months after operation [(0.60 ±0.35) D vs.(0.58 ±0.30) D,P ＞0.05].Conclusions Corneal astigmatism is prｅsent in most cataract surgery candidates.Cataract surgery using steepest corneal meridian incision induces significantly less SIA,and correct corneal astigmatism already present preoperatively.

Medicine, Chinese Traditional