Objective Analyzing and summarizing the characteristics and clinical data of 238 cases of unexplained fever in patients with normal or decreased white blood cell count, to guide the clinical diagnosis and treatment in feverish pa-tients with normal or decreased white blood cell count.Methods In the department of hematology 238 cases of fever in pa-tients with normal or decreased white blood counts have been collected from January 2009 to December 2013.Retrospectively analyze their clinical manifestations, related auxiliary examination, and diagnostic process and treatment.Results 234 cases in the total 238 cases had confirmed diagnoses, of which the rate was 98.3%.Of the total 238 cases, 176 cases (73.8%) were diagnosed with infectious diseases; 17 cases (7.2%) were diagnosed with malignancy; 6 cases (2.5%) were diag-nosed with connective tissue disease;35 cases (14.8%) were diagnosed with other diseases;diagnoses of 4 cases (1.7%) were not confirmed.Conclusion Most patients with fever can have a confirmed diagnosis after a detailed history and physical examination.The main cause of fever is infection.Fevers with normal or decreased white blood cell count have their particular clinical manifestations which should be concerned, targeted and treated accordingly as soon as possible.

60 years.

Objective To evaluate the accuracy of preoperative MRI in the diagnosis of malformations associated with MRKH syndrome and identification of uterine endometrium to optimize the clinical management.Methods 1 8 females with primary amenor-rhea were studied with MRI performed with a 1.5T or 3.0T imager.All patients were examined in the supine position using a phased-array coil and underwent pelvic MRI.Two experienced radiologists evaluated all the examinations in consensus to assess the pres-ence,position and morphology of vagina,uterus,ovaries and any pelvic abnormalities.Results One or two rudimentary uteri were identified in 17 patients (94.4%).A total of 16 patients (88.9%)had bilateral rudimentary uteri,1 (5.6%)had unilateral rudimentary uteri(it was left sided).1 (5.6%)had no uterine remnants.4 (12.1%)of 33 uterine buds in 4 patients showed differentiation of the center of the uterus into three layer.Bilateral ovaries were present in 1 7 patients,and their shapes,sizes and signals are normal.The vagina and cervix were absent in all cases.Conclusion MRI is a useful diagnostic tool in the preoperative evaluation of MRKH syndrome and the endometrium to further optimize the treatment plan.

ety, reduce the risk of infection and improve the efficiency of nursing service.

Objective To study the expression of intercellular adhesion molecule-1 (ICAM-1 ) in the rat cardiac heterotopic allo- grafts and the effect of cyclosporin A on prevention of allograft rejection. Methods Heart transplantated animals were divided into three groups: Group Ⅰ(control), Group Ⅱ(CsA 7. 5mg/kg B W, daily) and Group Ⅲ(CsA l5mg/kg B W, daily). Acute cardiac rejection grade was valued by the standrd of ISHLT(1990 ). Immunohistochemistry was performed to analyze the expression of ICAM-1 in heart grafts and donor aorta segments. Results After heart transplantation, it was found that from day 1 to 3, there was sligtly inflammatory infiltratiation, the rejection was graded 1A of 1B, But from day 11 to 12, there were disseminated inflammation and cardiac necrosis with serous hyperemia, exutation, edema, acute vasculitis and myocarditis. The rejection grade was 3B or 4, and could be reduced 1to 2. 5 grades by administration of CsA. It was also found that both in heart graft and donor aorta segments the expression of ICAM-1 on the endothelium cells, infiltrated lymphocytes was clearly increased. It was time-dependent and could be down-regulated by administra- tion of CsA. On Day 1 and Day 3 the suppressing function of CsA on expressing of ICAM-1 showed singificant dosage-dependent. But from Day 7 to Day 11, it appeared dosage- independent. Conclusiou Trea tment with CsA is an effect ive methed to down- regulate I - CAM-1 expression and could reduce the lympphocyte migration and filtration. These results may explain, in part, the mechanism of CsA reducing acute rejection in a rat cardiac transplantation medel.

Objective To explore the value of DWI and 1 H-MRS in evaluation of malignant degree of primary osteosarcoma.Methods A retrospective analysis was performed in 41 patients with osteosarcoma confirmed pathologically and examined with DWI and 1 H-MRS.The b values were 0,400,800,1 000 and 1 500 s/ mm2 in DWI,respectively.ADC map was obtained,and ROIs were selected to measure ADC values.Eighteen cases which had stable spectral lines in MRS were selected and analyzed.The spectral lines,Choline (Cho),Creatine (Cr) and Cho/Cr ratio were obtained.Analysis of ADC values of high and low grade osteosarcoma were performed with Kruskal-Wallis H test,and Cho/Cr values were analyzed with Mann-Whitney U test.Results When b values were 400,800,1 000 s/mm2,ADC values of high and low grade osteosarcoma were significantly different (x2=6.26,4.37,4.87,P=0.01,0.04,0.03).When b value was 1 500 s/mm2,ADC value of high and low grade osteosarcoma had no statistical difference (x2 =2.39,P=0.12).Moreover,when 400 s/mm2 was taken as the optimal b value,the specificity and sensitivity of ADC value for identifying high grade osteosarcoma was 73.30 ％ and 72.70 ％,respectively.Cho/Cr values between high and low grade osteosarcoma were significantly different (Z=-2.45,P＜0.05).As a diagnostic parameter,the best threshold value of Cho/Cr was 2.21.And the specificity and sensitivity for diagnosing high grade osteosarcoma was 75.00 ％ and 92.90 ％,respectively.Conclusion ADC (b=400 s/mm2) and Cho/Cr values may be helpful to identifying malignant degree in osteosarcoma.

Objective To assess MR characteristics of supratentorial intraparenchymal ependymomas(SIEs)in different age groups.Methods 40 patients with SIEs confirmed by surgery and pathology were analyzed retrospectively.All patients were examined by head MRI without or with contrast.Patients were divided into two groups according to age:child and adult group.T test was used to analyze the difference of tumor volume of two groups.Mann-Whitney U test was used to compare cystic,edema and pathological types of two groups.χ2test was used to distinguish sexual distinction.Results 39 cases of SIEs were located in cerebral surface,1 case located in inside cerebral essence.SIEs of child group(n=13)were male dominance(n=11),5 cases were located in the frontal lobe,all lesions were cystic solid masses.In the adult group(n=27),13 cases were male,9 cases were located in the frontal lobe,solid tumors were seen in 3 cases.There were significant difference among two groups in sexual distinction(χ2=3.921,P=0.048)and cystic change(U=98.50,P=0.02).There were no significant difference in the volume of tumor(t=1.828,P=0.087),edema(U=219.00,P=0.49)and pathological types(U=258.00,P=0.10).Conclusion There are MR characteristics differences in the SIEs in different age groups.Child has a superiority of male,tumors are mainly as cystic-solid mass,edema of the tumor is mild and has a high incidence cystic necrosis,the border is clear.In adult group,tumors are mainly as cystic-solid mass,and can also be solid mass, the solid portion of the lesion is easy to bleed,edema of the tumor is serious.

Objective To investigate the effect of bibliotherapy in soothing the postoperative pain in children and relieving the perioperative anxiety of children and their care givers. Methods Hospitalized children and their care givers from August 2007 to March 2009 were studied. 153 cases from August 2007 to May 2008 were assigned to the control group and the other 153 cases to the intervention group. Routine surgical nursing were applicated in the control group by introduction of perioperative nursing procedures.Bibliotherapy were applicated in the intervention group on the basis of the control group-using "bibliotherapy materials for hospitalized children" which was designed by ourselves and correspond with the theory of bibliotherapy to interfere in the 153 cases in the intervention group. The variance of preoperative anxiety of care givers and perceptions of postoperative pain of children between the two groups were compared with scales of mYPAS, STAI and FLACC and Wong- Baker Facial Scale. Results The scores of mYPAS in children of the intervention group and the control group was (35.875+4.441)and(46.796+8.606 )respectively and the variance was significant. The scores of STAI in care givers of the two groups was(38.125+4.371 )and (49.901 +7.420) respectively and revealed significant variance. The scores of Wong-Baker and FLACC in children of both groups 1 hour after operation were compared and revealed no statistical significance. The scores of Wong-Baker and FLACC in children at 6 hours and 24 hours postoperative were compared subjectively and objectively and revealed statistic significance. Conclusions Bibliotherapy can ameliorate the anxiety level of both children and their care givers, relieve the perception of postoperative pain in children and improve their comforts. Bibliotherapy thus conduces to the recovery of postoperative children.

Objective To identify and rename one strain stored in National Center for Medicine Culture Collections ( CMCC) and used for tracheitis vaccine production. Methods The test strain CMCC (B)29108 and the type strain DSM30007T were cultured on NA medium. Characteristics in morphology, physiology, biochemistry and fatty acid profile were compared between the two strains. Phylogenetic analysis was based on 16S rRNA and rpoB gene sequences, together with the DNA-DNA hybridization assay. Results A Comparative analysis of a partial sequence of the 16S rRNA gene sequence revealed that the CMCC( B) 29108 strain was closed to the Acinetobacter species and showed the highest similarity with the type strain Acinetobacter baumannii DSM30007T. Moreover, the CMCC(B)29108 strain was highly similar to type strain DSM30007T in morphology, physiology, biochemistry and fatty acid profile. On the phylogenetic tree based on 16S rRNA and rpoB gene of all Acinetobacter members, the CMCC(B)29108 strain steadily clustered into one independent branch only with the DSM30007 T strain with a DNA-DNA hybridization value of 100%. Conclusion The CMCC(B)29108 strain that is one of the strains used for the production of tracheitis vac-cine should be assigned to the species of Acinetobacter baumannii based on its phenotypic, phylogenetic and chemotaxonomic characteristics.

OBJECTIVE: To study the role of JNK (c-Jun N-terminal kinase) signal transduction pathway on the nasal mucosa remodeling in allergic rhinitis rats, to explore whether IL-1β participates the nasal mucosa remodeling in allergic rhinitis by JNK signal transduction pathway. METHOD: Totally 60 male Wistar rats (weighing about 200-250 g)were randomly divided into A (AR group) and B group (control group). The rats in A group were sensitized for inducing AR by intraperitoneal injection ovalbumin and Al(OH)₃. Ovalbumin was respectively dropped in each nasal cavity of every rat for 4,8,12 weeks(A4,A8,or A12 group) each had 10 rats. The rats in B group were sensitized by intraperitoneal injection saline. Saline was respectively dropped in each nasal cavity of every rat for 4,8, 12 weeks(B4, B8, or B12 group), and each had 10 rats. The concentration of IL-1β in serum and nasal lavage fluid were tested by ELASA. The protein expressions of P-JNK and P-c-Jun were detected by immunohistochemical technique. Linear correlation analysis showed the correlation between levels of IL-1β in serum and P-JNK protein, levels of IL-1β in nasal lavage fluid and P-JNK protein. RESULT: The concentrations of IL-1β in serum and nasal lavage fluid of A group were all significantly higher than those of the corresponding B group (all P < 0.01). Compared with A4 group and A8 group, concentrations of IL-1β in nasal lavage fluid of A12 group were significantly increased (all P < 0.01). However the levels of IL-1β in serum were not significantly different among them (all P > 0.05). Mean absorbance values of P-JNK and P-c-Jun in A group were significantly higher than those in corresponding B group (all P < 0.01) and compared with A4 group and A8 group, those of A12 group were significantly increased (all P < 0.01). Strong positive correlation were found between P-JNK and concentration of IL-1β in serum or nasal lavage fluid (r = 0.835 and r = 0.902, all P < 0.01). CONCLUSION JNK signal transduction pathway plays important role in the nasal mucosa remodeling in allergic rhinitis rats. IL-1β participates in AR nasal mucosa remodeling possibly partly through activating JNK signal transduction pathway.
Animals ; Disease Models, Animal ; Interleukin-1beta ; metabolism ; JNK Mitogen-Activated Protein Kinases ; metabolism ; MAP Kinase Signaling System ; Male ; Nasal Mucosa ; pathology ; Ovalbumin ; Paranasal Sinuses ; Rats ; Rats, Wistar ; Rhinitis, Allergic ; metabolism ; pathology ; Signal Transduction