Objective To evaluate the diagnostic value of peripheral blood T-SPOT.TB and pleural effusion′s adenosine deami-nase(ADA)activity in patients with tuberculous pleurisy.Methods Sixty-two patients with suspected tuberculous pleurisy were enrolled in the study,whose peripheral blood T-SPOT.TB and pleural effusion ADA were measured and the best diagnostic thresh-old was determined by ROC curve.Results According to the diagnostic criteria of tuberculous pleurisy,24 patients were diagnosed with tuberculous pleurisy,33 were non-tuberculous pleurisy and 5 undiagnosed in the end.The sensitivity of T-SPOT.TB for the diagnosis of tuberculous pleurisy was 91.7 %,the specificity was 81.8%,Positive predictive value was 78.6%,negative predictive value was 93.1%.The ADA activity was (40.5±15.4)IU/L in tuberculous pleurisy group,which was higher than in non tubercu-lous pleurisy group[(2.4 ±9.5 )IU/L](P <0.01 ).The cut-off value of ADA was 22.5 IU/L in tuberculous pleurisy diagnosis, while its sensitivity and specificity were 83.3% and 84.8% respectively.The sensitivity of the combined detection of T-SPOT.TB and ADA was 95.8%.Conclusion The combined detection of peripheral blood T-SPOT.TB and pleural effusion ADA has a higher sensi-tivity in diagnosis of tuberculous pleurisy,and has important auxiliary diagnostic value for patients with suspected tuberculous pleurisy.

Objective To investigate the characteristics of apparent diffusion coefficient (ADC)values in the normal fetal kidney and to explore the normal data reference of fetal kidney by using diffusion-weighted imaging (DWI).Methods 71 normal kidneys of fetuses confirmed by ultrasound and MR were examined with DWI with four b values of 100 s/mm2 ,200 s/mm2 ,500 s/mm2 and 700 s/mm2 ADC values of the symmetrical ROIs were compared between left and right kidney for each b value.While ADC values between different group in ipsilateral kidney were compared between different b values.And the relationship between ADC values and gestational age was also evaluated.Results When b = 100 s/mm2 ,there was a statistically significant difference between the ADC value of left and right kidney,and the remaining group showed no statistically significant differences between the ADC values of left and right kidney.Comparisons among different b values of ipsilateral kidney showed statistically significant differences among the groups with different b values except the comparison between b=100 s/mm2 and b=700 s/mm2 groups of the right kidney with the increase of gestational weeks,the ADC values of bilateral kidneys were declining,and there was a reflection of this trend in different b values. Conclusion It is feasible for using DWI to evaluate the fetal kidney development.With a selected different b value,ADC value is a specific quantitative parameter that could help evaluating normal fetal kidney development.

Gastrins ; metabolism ; Gonadal Steroid Hormones ; metabolism ; Growth Hormone ; metabolism ; Hormones ; metabolism ; Humans ; Liver Diseases ; metabolism ; Thyroid Hormones ; metabolism

Objective To study the validity of furosemide test for predicting the hematoma enlargement in pa- tients with hypertensive cerebral hemorrhage.Methods Four hundred fifty-one patients with hypertensive cerebral hemorrhage were diagnosed using CT after oneset of the disease and 24 h reexamined 24 h after.The incidence of enlarged hematoma was evaluated by comparison the baseline and 24 h CT scanning.Furosemide(20 mg iv)was ad- ministered and blood pressure was measured 30 min after furosemide.Results The decreasing level of MAP after furosemide was significantly inversely related with incidence rate of hematoma enlargement{ r=-0.94,t=58.4,P 10 mmHg as the cut-off point,with the rate of hematoma enlargement as being 6.4 %,MAP decreased≤10 mmHg was associated with increases in prevalence of hematome to 33.2 %(?~2=51.82, P

OBJECTIVE To investigate the status of nosocomial infection in community health services and offer a scientific basis for nosocomial infection control.METHODS Totally 5738 outpatients were investigated retrospectively for nosocomial infection in community.RESULTS The most frequently nosocomial infection sites were lower respiratory tract,and next upper respiratory tract and urinary tract(2131,1045 and 934,respectively).The major reasons of causing the nosocomial infection were irrational usage of antibacterial drugs(39.0%),invasive procedures(31.0%) and using glucocorticoids(10.0%).Most of the pathogenic bacteria of the nosocomial infection were Gram-negative and the next were Gram-positive and fungi.74.4% of the pathogens were resistant to most of antibioties.CONCLUSIONS Alzeimer′s disease patients in the community health centers are popular and susceptible to infection.

Adult ; Female ; Humans ; Male ; Middle Aged ; Occupational Exposure ; Xylenes ; poisoning ; Young Adult

Animals ; Animals, Newborn ; Cell Hypoxia ; Cell Lineage ; Cell Proliferation ; Cells, Cultured ; Oligodendroglia ; cytology ; Rats ; Rats, Sprague-Dawley

Objectives To study the effect of preoperative platelet transfusion for splenectomy and devascularization in the prevention of intraoperative and postoperative bleeding.Methods The 230 patients with cirrhosis and portal hypertension who received splenectomy and periesophagogastric davascularization were divided into strata A,B and C according to the platelet counts.Stratum A patients had a platelet count of less than 30× 10/L,B between 30× 10/L and 50× 109/L,and C more than 50 × 109/L.The patients in each stratum were then randomly divided into a preoperative transfusion group (T group) and a non-transfusion group (NT group).The amounts of intraoperative bleeding,postoperative drainage in 48 hours after operation,rates of postoperative bleeding,and general medical conditions were compared.Results A comparison in stratum A showed lower amounts of intraoperative bleeding and 48 hour postoperative drainage,and a lower rate of bleeding in the T group (P＜0.05).There were no significant differences between the T and the NT groups in strata B and C (P＞0.05).Conclusions For patients with a platelet count lower than 30 × 109/L,preoperative platelet transfusion significantly reduced bleeding suggesting that preoperative platelet transfusion for splenectomy and periesophagogastric devascularization should be a routine.For those patients whose platelet count was above 30 × 109/L,platelet transfusion is not recommended.

Objective To explore pathogenes and pathogenesis of acute cerebral infarction (ACI) from the perspective of integrated traditional and western medicine.Methods To categorize the tongue and pulse manifestation of 64 ACI patients and calculate their frequency,constituent ratios.Meanwhile,patients' blood pressure and laboratory examination results are given descriptive and statistical analysis,showing their means and standard deviations,etc.Results The frequency of dark-red tongue,thin-greasy tongue fur,greasy-yellow tongue fur and taut-slippery is respectively 48,34,20,and 41,constituting 77.4％,54.8％,32.3％,64.1％ of the patients examined respectively; Mean and standard deviation of systolic blood pressure (SBP),total cholesterol (TC),white blood cell (WBC),neutrophil percentage (NEUT％),fasting plasma glucose (FPG),and hemoglobin A1c (HbA1c) is respectively (141.20± 19.20)mm Hg (1 mm Hg=0.133 kPa)、(4.47±0.97) mmol/L、(7.83±2.63) × 109/L、(71.61±9.65)％、(6.16±2.25)mmol/L、and (6.60±1.66)％.Conclusion In terms of pathogens,wind,stasis,heat (fire) and turbid pathogen (phlegm,dampness,etc.) are important factors in bringing out ACI; In respect of ACI pathogenesis characteristics,healthy qi is slightly damaged and pathogenic qi is exuberant.Yet,the role of modern medical examination results,such as blood pressure,blood glucose,blood lipids etc.in the assessment of ACI pathogens and pathogenesis awaits further exploration.

ObjectiveTo explore the therapeutic effect of continuous veno-venous hemofiltration (CVVH) on the treatment of severe acute pancreatitis (SAP).MethodsAll data about forty-five patients with SAP admitted to the intensive care unit (ICU) from June 2005 through June 2010 were reviewed.These 45 patients were randomly (random number ) divided into routine treatment group (n =22 )and comprehensive treatment group ( n =23 ).In control group,patients were rapidly given with a suffficient liquid support,vasoactive drug to increase organ perfusion,trypsin secretion inhibitor,broad-spectrum antibiotics,enteral nutrition with intestine membrane protective agent in early stage.In the comprehensive treatment group,patients received CVVH integrated with routine treatment.On admission and 72 h posttreatment,the scores of acute physiology and chronic health evaluation Ⅱ ( APACHE Ⅱ ) and multiple organ dysfunction syndrome (MODS),and the results of standard bettery of biochemistry tests indcluding blood urea nitrogen (BUN),serum cratinine (Scr),total bilirubin (TBIL),alanine aminotransferase (ALT),amylase (AMS),C-reactive protein (CRP),TNF-α,IL-6,IL-8 were observed.Time of mechanical ventilation support,length of ICU stay,and survival rate were compared between two groups.ResultsOn admission between the two groups,no statistical significance was seen in the APACHE Ⅱ and MODS score,BUN,Scr,TBIL,ALT,AMS,CRP,TNF-α,IL-6,IL-8 (P ＞ 0.05).But APACHE Ⅱ and MODS score were decreased significantly in comprehensive treatment group than in the routine treatment group,as well as the the level of BUN,Scr,TBIL,ALT,AMS,TNF-α,IL-6,IL-8 and CRP after 72h post-treatment (P＜0.05 ).In routine treatment group and comprehensive treatment group,the time of respirator intervention and length of stay in ICU were (7.6±3.4) d vs.(11.5±4.7) d,(12.3±7.8) dvs.(17.6±9.2) d respectively,the statistical significance was shown ( P ＜ 0.05 ).Compared to the comprehensive treatment group ( 86.96％ ),the survival rate ( 59.09％ ) were lower in routine treatment group ( P ＜ 0.05 ).ConclusionsCVVH combined with routine treatment,which can remove inflammatory agents and toxins,maintain homoeostasis,and improve oxygenation,is effective in treatment of SAP and can improve patient survival rate.