The A/G polymorphism of cytotoxic T lymphocyte associated antiger 4(CTLA-4) was determined by PCR-RFLP in 120 patients with recurrent Graves′ disease (GD), including 85 cases with early relapses within 3 years and 35 cases with relapses more than 3 years after withdrawal of antithyroid medication.66 initial GD patients and 100 healthy controls were included in the present study.The results suggest that A/G polymorphism of CTLA-4 was associated not only with GD, but also with early relapes after withdrawal of antithyroid medication.

AIM: To observe the efficacy and side effects of interferon ? 1b (interferon) combined with oxymatrine in the treatment of chronic hepatitis B. METHODS: 87 patients were randomly divided into two groups: 45 patients in treatment group were given interferon 30 ?g?d -1 (im) for 4 wk, then 30 ?g?d -1 (im, qod) combined with oxymatrine 600 mg?d -1 (im) for 3 mon; 42 patients in control group were given the same dose of interferon as above only. After completion of therapy, liver function and markers of HBVM were compared between the two groups. RESULTS: The rates of ALT decreased to normal range in treatment group and control group were 88.9 % and 60%, respectively (P

Foreign bodies in the paranasal sinuses are rare. Foreign bodies in the ethmoid sinus are easily misdiagnosed as tumor. There is no typical display in CT and MRI tests. The described case showed the misdiagnosis of an ethmoid foreign body as tumour on the basis of CT and MRI results. It should be emphasised that the tumour diagnosis should be based on further physical and histopathological examinations and not only on the results of CT and MRI tests.
Adult ; Diagnostic Errors ; Ethmoid Sinus ; Foreign Bodies ; diagnosis ; Humans ; Male ; Paranasal Sinus Neoplasms ; diagnosis

Objective To observe the analgesic effects of tramadol combined with atropine during the oocyte retrieval operation in assisted reproduction treatment(IVF/ICSI-ET)? Methods Three hundred patients(four hundred cycles of infertility totally)in the Center for Reproductive Medicine were equally assigned into treatment group and control group according to the different analgesia: the former were treated with intramuscular injection of 100 mg tramadol combined with 0?5 mg atropine for analgesia before the operation and the latter with 50 mg pethidine hydrochloride? The two groups were compared in terms of blood pressure,pulse,degree of pains, rate of fertility,rate of cleavage and rate of transplantable embryo? Result There were no differences between them in terms of blood pressure,pulse,pain degree,rate of fertility and rate of cleavage and rate of transplantable embryo(all P > 0?05),but the incidence of adverse effect in the treatment group was significantly lower than that in the control group(P < 0?05)? Conclusion The application of tramadol hydrochloride combined with atropine sulphatev for analgesia during oocyte retrieval operation of IVF-ET is advantageous for its safety,lower incidence of advers effect and stable vital signs?

BACKGROUND:To ensure the catheter position is very important for interventional catheters. In emergency, rapid and accurate catheter insertion is required. Ultrasound can real-time track the movement of catheters in vivo. It is safe to patient, which has exhibited a bright future in catheter placement. OBJECTIVE: To compare the current methods for improving ultrasonic localization methods and to prospect the future development and improvement of real-time ultrasonic localization of catheters in vivo. METHODS: Literature search was carried out based on PubMed (1990-01/2015-04) and Espacenet with the key words of catheter, ultrasonic guidance, ultrasound localization, enhanced localization for the initial retrieval of relevant articles. RESULTS AND CONCLUSION:To improve the image quality and increase the accuracy of catheter placement by ultrasound, recent efforts have been focused on two paths. One is to improve the resolution of ultrasonic images by enhancing ultrasound equipment or ultrasonic guidance system. The other is to modify catheter itself to obtain high acoustic impedance differential and improve its echogenicity. The latter approach can be potentialy applied in al kinds of catheters and is more economical and practical. Therefore, in future researches, innovation and design of catheter materials for catheter fabricating wil play an important role in promoting the real-time ultrasonic localization of catheters.

10.3969/j.issn.2095-4344.2013.25.013

Objective To explore the value of salivary glands ultrasonography in diagnosis of Sj(o)gren's syndrome (SS).Methods Ninety-two patients with symptoms of xerophthalmia or xerostomia were enrolled,and 42 of them were divided to the SS group and the others to non-SS group.The bilateral parotid and submandibular gland of all patients were examined with ultrasonography,then the ultrasonographic features of bilateral salivary glands were obtained.The imaging features of salivary glands were evaluated by a semi-quantitative scoring system.The differences of ultrasonography scores between SS group and non-SS group were compared.The value of semi-quantitative scoring system in diagnosis of SS was analyzed.Results Salivary gland ultrasonic manifestations of 38 patients (38/50,76.00％) in non-SS group were normal,whose ultrasonographic scores were 0.Whereas the ultrasound of 32 patients (32/42,76.19％) were abnormalities in SS group,whose ultrasonographic scores were ≥1.Ultrasonographic scores in SS group were higher than that of non-SS group (P＜0.001).The area under the ROC curve of ultrasound score in diagnosis of SS was 0.805 (P＜0.001,95％ confidence interval was [0.711,0.899]).When the cutoff value of the scores was 2,the sensitivity and specificity were 59.5 ％,and 92.0％.Conclusion The ultrasonographic scoring of salivary glands can provide a semi-quantitative index for inhomogeneity of the salivary glands,which has significant value in the diagnosis of SS.

Purpose To evaluate the value of acoustic radiation force impulse (ARFI) imaging in the diagnosis of SjOgren's syndrome (SS).Materials and Methods Sixty-four cases of outpatients or inpatients with xerophthalmia or xerostomia in the Department of Rheumatology and Immunology of the First Affiliated Hospital of Nanchang University from September 2015 to April 2016 were collected.According to American-European Consensus Group criteria of 2002,the subjects were divided into SS group (n=38) and nonSS group (n=26).The bilateral parotid gland and submandibular gland were examined by ARFI imaging,and the shear wave velocity (SWV) value was obtained.The differences in SWV values between the left and right sides of the parotid gland or submandi-bular gland and between the SS group and the non-SS group were analyzed.Results ① The SWV values between two sides of parotid glands or submandibular gland in SS group or non-SS group showed no significant differences (P＞0.05).The difference of SWV between the two groups was statistically significant (P＜0.05).② According to the ARFI imaging of parotid gland,the optimal cutoffvalue,sensitivity,specificity,Youden index and ROC area under the curve were 1.99 m/s,86.3％,80.8％,0.671 and 0.879,respectively.③ According to the ARFI imaging of submandibular glands,the optimal cutoff value,sensitivity,specificity,Youden index and ROC area under the curve were 2.13 m/s,79.5％,80.8％,0.603 and 0.878,respectively.Conclusion The ARFI imaging can provide the SWV value of salivary glands to quantify the elasticity of salivary glands in SS,which has great value in the diagnosis of SS.

The relevant policies of national essential medicine system were reviewed, major concerns and actions in the implementation of essential medicine system in Shanghai were introduced, and the suggestions to improve the implementation of essential medicine system of Shanghai were made. These provided the information for policy making and provided a useful experience for facilitating the establishment of essential medicine system and the improvement of its implementation in Shanghai as well as China.

Objective To investigate the performance of MicroScan WalkAway 96 Plus (MSW) system in detection of carbapenem-resistant Enterobacteriaceae (CRE).Methods A total of 81 stock CRE strains were used in this study. Bacterial identification and antimicrobial susceptibility test were performed by MSW system. Beta-lactamases genes blaKPC,blaIMP,blaVIM, blaOXA-48 and blaNDM were amplified by PCR and subjected to sequencing analysis. Disk diffusion method and PCR were used as gold standard to evaluate the performance and reliability of MSW system in identifying carbapenem-resistant and carbapenemase-producing Enterobacteriaceae.Results Overall, 69.1 % (56/81) of the Enterobacteriaceae strains were identified as CRE by the MSW system. The results of PCR showed that 48 strains were carbapenemase-producing Enterobacteriaceae. When carbapenemase-producing Enterobacteriaceae strains were identified by the instrument using an advanced expert system, the sensitivity was 93.8 % and specificity was 42.4 %. The positive predictive value was 70.3 %, the negative predictive value was 82.4 % and the predictive accuracy value was 72.8 %.Conclusions The MicroScan WalkAway 96 Plus system has shown good performance in detection of CRE.