Objective To investigate the value of soluble triggering receptor expressed on myeloid cells-1(sTREM-1) in the diagnosis of bacterial pleural effusion. Methods The levels of sTREM-1 in pleural effusion were determined in 30 patients with bacterial pleural effusion, 33 patients with malignant pleural effusion,31 patients with tuberculous pleural effusion and 28 patients with transudate by quantitative ELISA assay. The levels of CRP in pleural effusion were assayed using immunonephelometry method. The diagnostic value was assessed by receiver operating characteristic ROC curve analysis. Results The levels of sTREM-1［(1255.2±248.6)ng/L］ in bacterial pleural effusion were significantly higher than those in malignant ［（125.6±22.4）ng/L］, tuberculous［（184.5±36.5）ng/L］ and transudate groups［（92.5±20.8）ng/L］ (P＜0.05). For ROC curve, when the cut off value of sTREM-1 was set at 425 ng/L, the sensitivity , specificity ,accuracy, positive predictive value and negative value was 93.3%,90.3%,91.9%,93.2% and 93.3%, respectively. Conclusions Detection of sTREM-1 in pleural effusion is helpful to differentiate pleural effusion of bacterial origin from those with other etiologies.

Objective To analyze factors associated with long-term survival of acute leukemia(AL). Methods Clinical data is analyzed in 27 leukemia cases who had at least 5 years free survival (EFS). Combined intensive chemotherapy was administered under the principle of individualization to induce remission.Regular consolidation treatment after remission was strictly continued.Long-term follow up Was kept on,with the therapeutic regimen modified accordingly.Results Complete remission(CR) was achieved in 112 of 143(78.3%)AL patients and 27(18.9%)of them had survived more than 5 years.Conclusion The long-term survival of AL patients is related to the type of AL,leukemia cell burden,extramedullary leukemia, individual treatment,time required to achieve CR,continuous intensive chemotherapy and the regular postremission treatment.

Objective To optimize the prescription of flaxseed lignans sustained release tables by central composite design-response surface methodology.MethodsWith HPMC, EC and starch dosage as factors, and flaxseed lignans in 2, 6 and 12 h of cumulative release as evaluation indexes, central composite design-response surface optimization method was used to conduct prescription optimization experiments, and optimized prescription analysis was carried out.Results The optimal prescription of flaxseed lignans sustained release tables was as following: HPMC dosage was 43%; EC was 26%; starch content was 17%. Optimized index forecast values were very close to the observed values. In vitro release test of three selected optimal formulations indicated that there existed high approximation between the observed and estimated values.Conclusion It shows that the established model is suitable for flaxseed lignans sustained release tables, which can be used in the optimization of the prescription of flaxseed lignans sustained release tables.

Objective To explore the clinical efficacy of anterior superior malleolus flap and second toe transplantation for thumb reconstruction and soft tissue defect repair or first web reconstruction.Methods A total of 13 cases were underwent anterior superior malleolus flap and second toe transplantation for thumb reconstruction and soft tissue defect repair from June,2008 to January,2016.There were 9 males and 4 females.The average age was 25 years old,ranging from 18 to 52.There were 3 cases of Ⅲ-degree thumb defect with soft tissue defect of hand,6 cases of Ⅳ-degree thumb defect with soft tissue defect of hand,3 cases of single Ⅴ-degree thumb defect and 1 Ⅴ-degree thumb defect with soft tissue defect.There were 5 patients accompanied with injury of other fingers of the affected hand.And the thenar muscles were also damaged to a varied degree.There were 10 patients with soft tissue defect before surgery,with the wound surface ranging from 3 cm × 5 cm-6 cm × 13 cm.And the wound of other 3 cases was closed.After the surgery,follow-up visit was conducted on the appearance,sensation,function,daily life and working condition of reconstructed thumb,the appearance and function condition of donor site.Results The reconstructed thumbs and anterior superior malleolus flaps in 13 cases survived and healed primarily.The average post-operative followed-up time was 5.5 years,ranging from 2.5 to 10.0 years.The appearance of reconstructed thumb was satisfactory,and the temperature sensation,pain sensation and touch sensation were recovered.The two-points discrimination was 8-18 mm.Moreover,the flexion and extension function,opposing function and finger-to-thumb function was recovered,which could meet the demand of daily life and work.The appearance of donor site was satisfactory,without claudication,pain or dysfunction.The survival of transplanted skin area in the calf was good,with no ulcer noticed.According to the Trial Standard for Thumb and Finger Reconstitution Functional Assessment of Hand Surgery Society of Chinese Medical Association,there were 10 cases excellent results,2 good and 1 fair.Conclusion Application of anterior superior malleolus flap and second toe transplantation for first-stage thumb reconstruction and soft tissue defect repair or thenar muscles and first web reconstruction is an effective therapeutic approach.