Objective To explore the value of adenosine deaminase (ADA),interferon (IFN)-γand soluble interleukin-2 receptor (sIL-2R) in differential diagnosis of tuberculous and malignant pleural effusion.Method The ADA activity,IFN-γ and sIL-2R levels of 48 patients with tuberculous pleural effusions and 32 patients with malignant pleural effusion were measured by colorimetry and ELISA respectively.Results The ADA activity,IFN-γand sIL-2R level in tuberculous pleural effusion was higher than that in malignant pleural effusion (P < 0.05).According to the receiver operator characteristic (ROC) curve,when 45 U/L was regarded as critical value of ADA,the sensitivity,specificity and accuracy of ADA in diagnosing tuberculous pleural effusion was 82%,91% and 86% ; when 100 ng/L was regarded as critical value of IFN-7,it was 85%,94% and 89%; when 450 μg/L was regarded as critical value of sIL-2R,it was84%,81% and 83%.When combined detection of three targets was done.it was 88%,100% and 94%.Conclusion The combined detection of ADA,IFN-γand sIL-2R can improve sensitivity,specificity and accuracy in diagnosing tuberculous pleurisy.

Objective To investigate the effect of enteral nutrition support on prognosis in patients with severe acute stroke.Methods Ninety-eight cases of severe acute stroke were divided into nutrition supported group(50 cases) and control group(48 cases) randomly.All patients were treated by conventional therapy.Nutrition supported group received high energy nutrition diet and control group received common liquid diet by nasal feeding.The levels of hemoglobin,serum albumin,neurologic impairment score (NIHSS)and the incidence rates of complications were assessed at the 1st,10 th and 21st day after admission.Results Hemoglobin was (122.5 ± 2.4),(106.4 ± 2.8) g/L and serum albumin was (36.5 ± 4.7),(34.2 ± 5.1) g/L at the 21st day after admission in nutrition supported group and control group,and there was significant difference between two groups (P < 0.05).The complication rate in control group was higher than that in nutrition supported group (P< 0.05).NIHSS score was(8.45 ± 3.02) scores in nutrition supported group and (10.24 ± 2.57)scores in control group at the 21st day after admission,and there was significant difference between two groups (P <0.05).Conclusion Early enteral nutrition support can significantly improve nutritional status and decrease the incidence rates of complications in patients with severe acute stroke,and it is helpful for clinical prognosis.

Objective To observe the therapeutic effects of exercise combined with tiotropium bromide and salmeterol/fluticasone inhaling on stable chronic obstructive pulmonary diseases (COPD).Methods Sixty COPD patients with pulmonary function Ⅲ-Ⅳ grade were randomly allocated into experiment group and control group (30 cases in each group).The patients in experiment group were treated with inhaled tiotropium bromide and salmeterol/fluticasone combined with excise,while the patients in control group were treated only with inhaled tiotropium bromide and salmeterol/ fluticasone.Respiratory training with shrinkage lip respiration and steps training was given to the patients in experiment group for 8 weeks.Main outcome measures included forced expiratory volume in one second (FEV1),FEV1,in the anticipation value (FEV1%),FEV1/forced vital capacity (FVC),Medical Research Council (MRC) score,activities of daily living (ADL) score and 6-minute walking distance (6MWD).Results MRC score in control group and experiment group was both lower than that of pre-treatment (P < 0.01).ADL score,6MWD and pulmonary functional parameters in both groups were improved than those of pre-treatment (P< 0.01).FEV1,FEV1%,FEV1/FVC,MRC score,ADL score and 6MWD were (1.41 ±0.25) L,(53.76 ±11.17)%,(62.12 ±10.78)%,(1.56 ± 1.16) scores,(5.51 ±0.18) scores and (342.7 ± 19.7) m after treatment in experimentgroup,and (1.28 ± 0.23) L,(46.27 ±8.85)%,(55.76 ±8.57)%,(2.29 ±1.13)scores,(4.47 ±0.13)scores and (280.6 ± 17.8)m after treatment in control group.There were significant differences between two groups (P<0.05).Conclusion Tiotropium bromide,salmeterol/ fluticasone inhaling can improve life quality and pulmonary functional parameters in patients with stable COPD,while exercise combined with that can significantly enhance the therapeutic effects.

Objective To discuss the clinical characteristics of diagnosis and treatment of primary gastric malignant lymphoma (PGML). Method The data from 34 PGML medical records were reviewed retrospectively between January 2001 and May 2008. Results There were 23 cases of B-cell malignant lymphoma, 7 cases of T-cell malignant lymphoma, and 4 cases of non-B and non-T small cell lymphoma. Confirmed by pathology, 14 cases of them had metastasis to lymphoid nodes and 5 cases had invaded the organs nearby. All of these 34 cases had gastroendoscopy before operation. Conclusions PGML has no specific manifestation, and the definitely diagnostic rate of gastroendoscopy is low. The surgical resection is the major therapy.Operative pattern,the size of tumor,pathological stage can predicate the prognosis for PGML.

Objective To investigate the feasibility and safety of combined coronary and renal angiographies through transradial approch.Methods Three hundred and twenty patients in hospital from August 2007 to April 2009 who underwent combined coronary and renal angiographies through transradial approach were included in this study.Renal artery angiography of 300 cases was done by 5 FMP-A1 catheter (MP-A1 group),and 20 cases was done by TIG catheter (TIG group).Control group had 625 patients in hospital from January 2004 to April 2009 who underwent combined coronary and renal angiographies through transfemoral approach.The achievement ratio,operating time,dosage of contrast agent and complication of angiography were observed.Results The achievement ratio was higher in MP-A1 group [97.0%(291/300) ]and control group [98.4%(615/625)]than that in TIG group [40.0%(8/20)](P< 0.01).The operating time was (32.21 ± 3.37) min and the dosage of contrast agent was (52.72 ± 7.91) ml in MP-A1 group,and it was (30.78 ± 3.23) min and (51.88 ± 7.22) ml in control group respectively.There was no significant difference between two groups(P>0.05).The operating time was (26.42 ±4.31) min and the dosage of contrast agent was(51.72 ± 10.11) ml in TIG group.There was significant difference in the operating time between TIG group and the others groups (P < 0.05).The complications of angiography through transradial approach (0.9%,3/320) were less than those through transfemoral approach (3.0%,19/625) (P <0.05).Conclusions Renal artery angiography through transradial approach by 5 F MP-A1 catheter(125 centimeter) is safe and has minor complication.The achievement ratio of transradial approach for renal artery angiography by 5F MP-A1 catheter is higher than that by TIG catheter.

Objective To explore the relationship between obesity levels and adipocytokines like leptin,adiponectin and resistin in children.Methods One hundred and ten patients aged 2-6 years with simple obesity were selected into obesity group,which included 40 cases of slight obesity (slight obesity group),40 cases of medium obesity (medium obesity group) and 30 cases of severe obesity (severe obesity group).Forty cases of healthy children with normal bodyweight were included in control group.Their serum leptin,adiponectin and resistin levels were tested and compared.Results Serum leptin and resistin levels in obesity group were remarkably higher than those in control group (P < 0.01),whereas adiponectin level was much lower than that in control group (P< 0.01).Serum leptin and resistin levels in medium obesity group were remarkably higher than those in slight obesity group [(14.3 ±1.9) μg/L vs (7.8 ± 1.5)μg/L and (14.6±2.2) μg/Lvs (13.1 ±3.0) μg/L](P< 0.01),whereas adiponectin level was much lower than that in slight obesity group[(6.7 ± 3.0) mg/L vs (9.1 ± 3.5) mg/L](P< 0.01).Serum leptin and resistin levels in severe obesity group [(20.4 ±4.7),(18.3 ±3.2) μg/L]were remarkably higher than those in medium obesity group(P< 0.01),whereas adiponectin level [(5.1 ± 1.2) mg/L]was much lower than that in medium obesity group (P< 0.01).Conclusion The levels of adipocytokines are closely correlated with obesity level in children,especially for abdominal obesity.

Objective To evaluate the therapeutic effect of botulinum toxin type A(BTX-A)injection in the treatment of spasmodic torticollis.Methods Sixty-four patients with spasmodic torticollis underwent the treatment of intramuscular injection of BTX-A in neck muscles.As a result,the efficiency of BTX-A therapy could be evaluated successfully.Results Considerable improvement of symptoms for the spasmodic torticollis patients was observed with BTX-A treatment.The average dose of BTX-A was(120.37 ±25.26) U.Injection points were 30.00 ± 4.85.The Tsui scores before treatment were (13.08 ±4.16) scores,and 2 weeks after treatment were (4.21 ± 2.63) scores.The Tsui scores showed a significant reduction after BTX-A injections (P <0.01).After treatment complete remission rate was 25.0% (16/64),significant improvement rate was 60.9% (39/64),partial improvement rate was 12.5% (8/64),invalid rate was 1.6%(1/64) and efficient rate was 85.9% (55/64).Duration of effect was (16.86-4.57) weeks.Patients who received repeated injections also had good response,with symptoms improved and dosage of BTX-A reduced.No serious adverse events happened in treatments.Conclusion BTX-A therapy is simple and effective in the treatment of spasmodic torticollis and should be considered as the first-choice treatment for the condition.

Objective To study the significance of Helicobacter pylori (Hp) infection and the expression of caudal-related homeobox transcription factor 2 (CDX2),mucin 2 (MUC2) proteins in gastric cancer,and elucidate the prognostic significance of CDX2,MUC2 proteins in gastric cancer.Methods Ninety cases of gastric cancer were available for the study.Hp was studied by Warthin-Starry bacterium stain and CDX2 and MUC2 proteins were studied by immunohistochemical stain.Results There was no Hp infection and no expression of CDX2 and MUC2 proteins in normal gastric mucosa.The positive rate in the cases of intestinal-type gastric cancer was 67.86%(38/56) for Hp,75.00% (42/56) for CDX2,and 66.07%(37/56) for MUC2,respectively,and it was higher than that in the cases of diffuse-type gastric cancer,which was 35.29%(12/34),41.18%(14/34) and 38.24%(13/34) respectively (P<0.01 or < 0.05).In intestinaltype gastric cancer,the positive rate of CDX2 and MUC2 proteins was also higher in Hp positive cases than that in Hp negative cases,and it was the same as CDX2 protein in diffuse-type gastric cancer.Higher positive rates of CDX2 and MUC2 proteins were observed in the cases of early gastric cancer than those in the cases of advanced gastric cancer (P < 0.01 or < 0.05),also it was observed in the cases of no lymph node metastasis than in the cases of lymph node metastasis (P < 0.01 or < 0.05).Moreover,the positive rate of CDX2 protein in the cases of stage Ⅰ～Ⅱwas higher than that in the cases of stage Ⅲ～Ⅳ (P < 0.05).Conclusions Hp infection and the expression of CDX2 and MUC2 proteins are related with gastric cancer,and has close relationship with intestinal-type gastric cancer.The expressions of CDX2 and MUC2 proteins may inhibit the infiltration and metastasis of gastric cancer.

Objective To study the level of interleukin(IL)-19 in peripheral blood of patients with asthma and investigate its importance.Methods Serum samples were obtained from 45 asthmatic patients (acute attack group and catabasis group) and 45 subjects (control group).The level of IL-19 and IgE in peripheral blood was respectively determined with ELJSA.The accurate number of eosinophile granulocyte (EOS) in peripheral blood was counted with cytoanalyze.Results The levels of IL-19,IgE and the quantity of EOS were (327.92 ± 245.79) ng/L,(260.48 ± 108.77) kU/L,(498.29 ± 96.46) x 107L in acute attack group,(165.54 ± 114.76) ng/L,(164.33 ± 59.08) kU/L,(224.67 ± 86.28) x 106/L in catabasis group,and (49.67 ±40.48) ng/L,(68.12 ± 25.70) kU/L,(31.84 ± 28.27) x 106/L in control group.Compared with control group,the levels of IL-19,IgE and the quantity of EOS in acute attack group and catabasis group were obvious higher than those in control group (P < 0.05).The level of IL-19 and the quantity of EOS in acute attack group were higher than those in catabasis group (P <0.05),but there was no significant difference in the level of IgE between acute attack group and catabasis group (P > 0.05).Furthermore,the results of correlation analysis showed that the level of IL-19 positively correlated with the level of IgE and the quantity of EOS respectively (r = 0.826 >0.738,P< 0.05).Conclusions The ascending degree of the IL-19 level is different during various periods of asthma.It may be inferred that IL-19 can play an important role in the pathogenesis of asthma,and observing the change of the IL-19 level dynamically is useful in diagnosing asthma and monitoring patient's condition.

Objective To observe the efficacy of continuous renal replacement therapy (CRRT) treatment in multiple organ dysfunction syndrome (MODS),and explore its application value.Methods Forty-six cases of MODS were treated with CRRT.Blood gas analysis,toxin removal,electrolyte and APACHE Ⅱ score was observed before and after treatment.Results The APACHE Ⅱ score in the beginning of treatment was (20.8 ±4.4) scores,31 cases had clinical cure,and APACHE Ⅱ score was (13.6 ±4.9)scores,15 cases died.In patients of survival,blood pressure,blood gas analysis,electrolytes,toxin removal improved gradually,and the difference had statistical significance before and after treatment.In 8 cases withshock before treatment who need drugs to maintain blood pressure,after treatment 6 cases withdrew drugs gradually.In the course of treatment,heart function was stable in patients who had heart failure.Four cases had pulmonary infection-induced MODS.In the process of the treatment internal environment was stable,and urine after treatment improved in different degrees.Two cases died of drug-resistant pathogens ultimately.Conclusions CRRT is an effective method in the treatment of MODS patients.CRRT can effectively clear the metabolites and inflammatory mediators,and rebuild the immune homeostasis of the body.