Objective To analyze the clinical value of serum and cerebrospinal fluid(CSF) procalcitonin in the diagnosis of adult central nervous system(CNS) infection to provide reference for its clinical diagnosis and treatment .Methods Sixty adult patients with CNS diseases admitted to our hospital from February to December 2015 were selected as the research subjects .All patients were suspected of CNS infection at initial visiting due to suspected CNS symptoms and signs ,and the CSF pathogenic examination and separation were performed to determine the types of infected pathogenic microorganisms .Meanwhile serum and CSF procalcito-nin was detected .The detection results of CSF pathogen and procalcitonin were summarized .The detection results of CSF pathogen served as the gold standard ,serum and CSF procalcitonin> 0 .5 ng/mL as infection positive .The diagnostic test fourfold table was adopted .Then the procalcitonin detection results and CSF pathogenic microorganism detection data were inputted .The consistency of serum and CSF procalcitonin for judging CNS infection was analyzed and calculated .The sensitivity ,specificity and accuracy of serum and CSF procalcitonin detection method for detecting pathogenic microorganisms were analyzed .Results Among 60 cases ,31 cases were bacterial infection ,22 cases were viral infection and no pathogenic bacterium was detected out in 7 cases ,the positive rate was 88 .34% .In the serum procalcitonin detection :49 cases were positive and 11 cases were negative ;in CFS procalcitonin detec-tion:37 cases were positive and 23 cases were negative .The Kappa coefficients of serum procalcitonin and CFS pathogenic detection results was 0 .769 ,indicating that serum procalcitonin and CFS pathogenic detection results had higher consistency ;the Kappa coef-ficients of CSF procalcitonin and CFS pathogenic detection results was 0 .315 ,indicating that CFS procalcitonin and CFS pathogenic detection results had poor consistency .The sensitivity ,accuracy and specificity of serum procalcitonin for diagnosing CNS infection were 96 .08% ,93 .33% and 77 .78% respectively ,which of CSF procalcitonin were 73 .33% ,45 .00% and 38 .46% respectively ;se-rum procalcitonin detection had a higher clinical value in the diagnosis of adult CNS infection ,while CSF procalcitonin detection had little value .Conclusion The serum procalcitonin detection method has higher sensitivity ,accuracy and specificity for the diagnosis of adult CNS infection ,possesses a better guidance role in selecting the treatment scheme and evaluating the curative effect ,and has higher clinical value in adult patients with CNS bacterial infection .

Objective To elucidate the relationship between LYVE-1 and VEGF-C and their expression in laryngeal squamous cell carcinoma(LSCC),and provide theoretic evidence for the judgement of metastasis and prognosis of LSCC,also for the treatment.Methods An immunohistocbemical analysis was performed to 50 specimens of LSCC with lymphatic endothelial marker LYVE-1.Quantitation of lymphangiogenesis growth factor VEGF-C by RT- PCR was performed to 30 specimens of LSCC.Finally the correlation between LVD and VEGF-C mRNA was analyzed with statistics methods.Results LYVE-1 (+) was observed in all LSCC.The median copy number of VEGF-c mRNA was 4-5-fold higher in LSCC than in adjacent normal tissue.There was correlation between tumor VEGF-C mRNA copy number and intratumoral LVD.Conclusion Lymphatic vessels existed in LSCC.There was correlation between high levels of LVD in LSCC than in normal tissue.The high level of VEGF-C may accelerate the lymphatic metastasis by promoting the proliferation of lymphatic vessel.

Objective To investigate the prevalence,incidence,death causes and natural course of nonalcoholic fatty liver disease (NAFLD) as well as the risk factors of NAFLD development in population of Guangdong province.Methods On the basis of previous epidemiological survey in 2005,3545 subjects were followed up (medium 4 years) for death causes.Of which,624 subjects (re-survey group) received interview,physical examinations,biochemical tests and ultrasonography again.The natural course and the risk factors of the NAFLD were analyzed.Results Of 3543 subjects,219subjects were failed to followed up and 4 out of 467 NAFLD patients (8.6‰) died of cardiovascular and cerebrovascular diseases during follow-up period.In rest 2857 subjects,22 (7.7‰) died of cardiovascular/cerebrovascular diseases and cancers.However,there were 117 NAFLD patients in resurvey group at the baseline.The NAFLD remained in 51 (43.6%) patients,aggravated in 26 (22.2%),alleviated in 21 (18.0%) and regressed in 19 (16.2%) at the endpoint.Meanwhile 185(36.5 %) out of 507 normal subjects developed NAFLD at the endpoint.The standard prevalence of NAFLD increased from 10.5% (2005) to 22.6% (2009,P<0.05).The standard incidence was 4.9% per year with male (5.1%) being higher than female (4.7%,P<0.05).The cumulative incidence was significantly higher in urban cities (43.1%) than in rural areas (27.4%,P<0.05).Cox proportional hazards regression showed that the age (OR= 1.893),waist circumference (OR=2.512),waist-to-hip ratio (WHR,OR= 1.400),body mass index (BMI,OR=2.581) and serum cholesterol levels (OR = 1.587) were associated with the development of NAFLD (P < 0.05).Multivariate regression logistic analysis revealed that age and BMI were associated factors for NAFLD.Decreased waist circumference was prone to remission.Conclusions The higher prevalence and incidence of NAFLD were noted in population of Guangdong province.The NAFLD patients mainly died of cardiovascular/cerebrovascular diseases,but not liver disease.Obesity,aging and dyslipidemia are high risk factors for NAFLD development.

Forty-four patients suffering from hip pain after the hip and femoral head replacement were treated by revision for total hip arthroplasty in Spinal and Joint Surgery of Gaozhou People’s Hospital between August 2000 and August 2006. Forty-one patients were followed up. The surgeon, an associate chief physician, had been engaging in artificial joint field for 9 years, and performed artificial joint replacement for 620 patients. ①There were 26 patients with pain after artificial femoral head replacement, including 17 males and 9 females with an average age of 72.3 years (range, 67-79 years). Of the 26 patients, 12 had loosening of prosthesis stem, 8 acetabular wear, 3 dislocation of artificial femoral head, 2 ossification around the joints, and 1 periprosthetic fracture. ②Fifteen patients suffered with pain after total hip replacement, including 9 males and 6 females with an average age of 73.4 years (range, 66-80). Of them, there were 6 with loosening of prosthesis, 2 with loosening of acetabular prosthesis, 2 with wear of acetabular prosthesis, 2 with dislocation of artificial femoral head, 1 with infection of incision, 1 with delayed infection, and 1 with periprosthetic fracture. ③During follow up, 4 cases developed bone cement response symptoms such as acute hypotension, hypoxemia, and arrhythmia, but no rejection induced by artificial joint was found. X-ray films showed that no metal corrosion or acetabular polyethylene prosthesis degradation occurred. ④White blood count was generally elevated the day after revision of total hip arthroplasty, and mostly recovered 7 days after revision. Three patients had venous thrombosis of lower extremities. All 41 patients were followed up for 1-7 years, and odynolysis rate was 90.2%. The results indicate that the complications such as loosening of prosthesis, acetabular wear, dislocation of artificial femoral head, and ossification around the joints are main causes of hip pain after hip prosthesis replacement. Revision of total hip arthroplasty is an efficient method to relieve the pain.

Objective To explore the clinical manifestations, electroencephalographic characteristics and therapeutic effect of drugs in children with Jeavons syndrome. Methods The clinical and electroencephalographic characteristics and thera-peutic effect of drugs were analyzed in 4 children with Jeavons syndrome. Results Among the four children there were 3 female and 1 male. The age at the onset of the disease was from 1 to 6 years. The typical clinical manifestations of this disease were brief, fast and repeated eyelid myoclonia (EM) with or without absence seizure. The typical electroencephalography (EEG) in two patients showed 3-6 Hz generalized spike and waves and polyspikes burst, and the eye closure and intermittent photic stimu-lation helped to induce discharges and clinical events. The typictal EEG in the other two patients showed 3.0-3.5 Hz generalizedδslow wave rhythm burst. The drugs of choice for treatment was sodium valproate monotherapy in two cases, levetiracetam in one case, sodium valproate combined with levetiracetam in one case. During the follow-up, seizures were controlled in one case, decreased in frequency in two cases and were still frequent in one case. Conclusions Jeavons syndrome is one of the idiopathic and generalized epileptic syndromes and characterized by EM with or without absence seizure. Video EEG monitoring plays an important role in the diagnosis of this disease. Sodium valproate and levetiracetam were effective for this disease.

Objective To discuss the standard diagnosis and treatment for thyroid nodule.Methods 2 581 patients with thyroid nodule from 2005 to 2009 were studied.Common methods of examination and treatment were analyzed to avoid over-examination and over-treatment.Results 90%of the patients underwent ultrasound examination with a 92.9%sensitivity and 44.3%specificity when there were two or more risk characters.All patients underwent certain kinds of surgery according to their clinical conditions.The recurrence rate was 4%two and half years after lateral thyroid adenectomy or thyroid surgery without excision of thyroid isthmus.Conclusions There are many approaches to thyroid nodule examination and treatment,in which ultrasound is recommended for preoperative examination because of its higher sensitivity,specificity and lower cost,and surgery is still the most useful and effective treatment.Choosing the proper method for thyroid nodule diagnosis and treatment is the key point to avoid over-examination and over-treatment.

Objectives To investigate the consumption of carbohydrate and distribution of dietary glycemic load (GL) in Chinese adults. Method Data from China National Nutrition and Health Survey in 2002 were used for this analysis. Dietary glycemic load was calculated as a function of glycemic index, carbohydrate content and frequency of intake of individual foods. Results Dietary glycemic load was contributed by 92% from cereals. People with low dietary GL /4184 kJ tended to consume more fat, less cereals, and less carbohydrates. The prevalence of overweight and obesity was higher in those with low GL/4184 kJ, especially in urban residents. Conclusion People with low GL/4184 kJ tend to consume more fat, less cereals, less carbohydrates. The situation in urban residents is more serious. Based on factors including cereals intake, energy contribution from fat and carbohydrates, prevalence of malnutrition, overweight and obesity. A proposed range for dietary GL /4184 kJ in Chinese adults can be 80~120.

Objectives To analyze the relationship between dietary carbohydrate and glycemic load(GL) and the plasma lipid level and dyslipidemia risk. Method The sample of adults above 18y of age from "National Survey on Nutrition and Health Status of the Chinese People 2002" was used,excluding pregnant women,mothers and people who controled their diets. Data of GI from China Food Composition 2002 and International Glycemic Index Table 2002 were used. The dietary GL as the indicator of dietary carbohydrate was calculated by multiplying the carbohydrate content of each food by its glycemic index,then multiplied by frequency of consumption and summed up from all food. Correlation analysis,multiple regression and Logistic regression were used to analyze the relationship between dietary GL and plasma lipid level and dyslipidemia risk. Results Dietary GL remained inversely associated with plasma total cholesterol(TC) and low density lipoprotein cholesterol(LDL-C) . With the increase of dietary GL,the risk of hypercholesterolemia and high blood LDL-C decreased. In the meantime dietary GL remained negatively associated with plasma high density lipoprotein cholesterol(HDL-C) . With the increase of dietary GL,the risk of low blood HDL-C increased. Dietary GL remained inversely associated with plasma triglyceride(TG) ,but showed no significant influence on risk of hypertriglyceridemia. Conclusion The traditional Chinese dietary pattern which is characterized by cereals as staple food is helpful to decrease dyslipidemia risk.

ObjectiveTo investigate the short-term efficacy, long-term efficacy, and adverse effects of elemene combined with transcatheter arterial chemoembolization (TACE) in the treatment of primary liver cancer (PLC). MethodsPubMed, EMBASE, Cochrane Library, Chinese Scientific Journal Full-Text Database, Wanfang Data, CBM, and VIP were searched by two reviewers using the same search strategy for clinical studies on elemene combined with TACE in the treatment of PLC. The Jadad quality scoring system was used to assess the quality of the studies included, and Review Manager 5.2 software was used for the meta-analysis. ResultsA total of 9 articles involving 487 patients were included. The results of the meta-analysis showed that compared with the TACE group, the elemene-TACE group showed significant increases in the response rate, disease control rate, and 12- and 24-month survival rates (response rate: RR=1.43, 95%CI： 1.23-1.67, P＜0.001; disease control rate: RR=1.22, 95%CI: 1.11-1.32, P＜0.001; 12-month survival rate: RR=1.68, 95%CI: 1.22-2.31, P=0.001; 24-month survival rate: RR=2.91, 95%CI: 1.44-5.87, P=0.003). As for the incidence of adverse events, the elemene-TACE group showed a significant reduction in the incidence rate of abdominal pain (RR=0.59, 95%CI: 0.36-0.98, P=0.04). ConclusionCompared with TACE alone, elemene combined with TACE might improve response rate, disease control rate, and survival rates and reduce adverse events in patients with liver cancer.

ObjectiveTo investigate the value of FibroScan combined with gamma-glutamyl transpeptidase-to-platelet ratio (GPR) in predicting liver fibrosis stage in patients with chronic hepatitis B (CHB). MethodsA total of 278 patients who were diagnosed with CHB by liver biopsy in Guangzhou Eighth People’s Hospital from January 2012 to December 2016 were enrolled. The value of GPR and FibroScan used alone or in combination in predicting liver fibrosis stage (F0-F4) was analyzed. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups and the Mann-Whitney U test was used for further comparison between two groups. The Spearman’s correlation coefficient was used for correlation analysis. The area under the receiver operating characteristic curve (AUC) was used to evaluate liver fibrosis stage. ResultsWith liver biopsy as the gold standard, of all patients, 50 had stage F1 fibrosis, 104 had stage F2 fibrosis, 92 had stage F3 fibrosis, and 32 had stage F4 fibrosis. Liver stiffness measurement by FibroScan gradually increased with the increase in liver fibrosis stage (P＜0.05), and GPR also increased gradually in patients with stage F1, F2, and F3 liver fibrosis (P＜0.05). GPR and FibroScan were positively correlated with liver fibrosis (r=0.419 and 0.481, both P＜0.001), and GPR was positively correlated with FibroScan (r=0.436, P＜0.001). According to AUC, FibroScan combined with GPR had a better diagnostic efficiency than FibroScan (0.793 vs 0.739, Z=3.044, P=0.002) or GPR (0.793 vs 0.740, Z=2.389, P=0.037) alone in predicting progressive liver fibrosis (≥F3); FibroScan combined with GPR had a better diagnostic efficiency than GPR alone (0.782 vs 0714, Z=2.130, P=0.033) in predicting marked liver fibrosis (≥F2). ConclusionFibroScan combined with GPR has a certain advantage in predicting progressive liver fibrosis (≥F3) in CHB patients and can improve diagnostic efficiency.