Objective To explore the significance and clinical value of continuous intracranial pressure monitoting in the treatment of brain injury.Methods 60 patients with severe brain injury were randomly divided into group of 30 patients (conventional treatment + continuous intracranial pressure monitoring), control group 30 patients( conventional treatment) ,disability,rate of successful treatment and efficacy renal function were compared after given mannitol. Results The loss rate of the observation group was 13％, and was lower than that of the control group (33％) (P ＜0. 05) :The successful rate of the observation group was 20％ ,and was higher than that of the controlgroup( 10％ )( P ＜ 0. 05 ). Conclusion In patients with severe brain injury, intracranial pressure monitoring was effective to reduce renal damage and reduce the loss rate increase treatment efficacy.

Objective To compare the clinical effect of different dose dexamethasone on acute low-frequency sensorineural hearing loss (ALHL).Methods 266 cases with ALHL were randomly divided into treatment group (136 cases) and control group (130 cases).On the basis of the comprehensive treatment,the treatment group received dexamethasone 40mg/d intravenous infusion,the control group was given dexamethasone 20mg/d.The treatment effect,average hearing threshold and recurrence were compared between the two groups.Results In the treatment group,the cure rate was 30.8％ (42/136),the effective rate was 50.0％ (78/136),invalid rate was 19.2％(36/136),the total effective rate was 80.8 ％.In the control group,the cure rate was 26.1％ (34/130),the effectiverate was 52.2％ (68/130),the invalid rate was 21.7％ (28/130),the total effective rate was 78.3％,the total effective rate between the two groups had no statistically significant difference (x2 =0.14,P ＞ 0.05).After treatment,125Hz,500Hz band,the average hearing threshold between the two groups had statistically significant differences (P ＜0.05).19 patients relapsed (19/120) in treatment group,the control group had a recurrence of 8 patients(8/102),the recurrence rate between the two groups had statistically significant difference (t =2.241,P ＜ 0.05).Conclusion Dexamethasone has good effect in treatment of ALHL.Small dose dexamethasone can reduce the recurrence rate and has no serious complications.

Objectives Appraise the quality of retired workers' life of a medical college according to their income, livelihood, neighborhood relations, health condition and other related factors. Methods Fill in the Quality of Life Investigation Questionnaire when the retired workers are taking routine physical examination. Results 776 pieces of questionnaire were collected, making up 64.7% of the retired workers, which may represent the people of this kind. Out of the 776 retired workers, 597 are suffering from chronic diseases, making up 76.9%. Among them, 37.5% have one type of chronic disease, while 39.5% have two types and more. Among them, heart cerebrovascular diseases and hypertension sufferers occupy 80.6%, 63.3% of the overall prevalence rate. 42.2% are satisfied with their health condition, 9.6% are not, 48.2% with fair contentment. Those with positive view towards income take up only 41.4%, while negative 6.6%. As to the way of living, 375 are living either with a spouse or by oneself, making up 50.6% ,while 46.2% living by a core family with children and grandchildren or with a big family. 64.0% are able to take care of themselves. Among the 236 in need, 88.0% are taken care of by relatives, only 12% by social aids. About 82.5% enjoy a harmonious family life;only 0.5% are not. 83.0% keep a good neighborhood relationship, only 0.6% of them doesnt. Conclusion The overwhelming majority of the retired workers of senior teachers and scientific and technical personnel are living in a harmonious family or community. When they are in need, relatives are the main forces to help, social forces does not work much on it. Two items that below 50% of the satisfaction are income and health condition. So, we are looking forward to the improvement of these two aspects by the reform on social and medical insurance.

OBJECTIVE To explore the main risk factors of fungal infection in lower respiratory tract(LRT) of hospital patients,strains distribution and sensitivity to common antifungal agents so as to provide basis for earlier diagnosis and effective treatment.METHODS Retrospective analysis was taken of the 76 cases with fungal infection in LRT in patients of Taizhou Hospital from Jul 2004 to Jun 2006 based on the diagnostic criteria for nosocomial infections by Ministry of Health of PRC and also following the definition given by European Organization for Research on Treatment of Cancer(EORTC) and us Mycosis study Groap(MSG) in 2002.RESULTS Of the 76 cases,84.2% were over 60 years old.All of them had underlying diseases.Sixty cases had been repeatedly treated with 2 or 5 antibiotics before fungal infection;21 cases received glucocorticoid;6 cases had chemol and radiotherapy and 21 cases underwent invasive treatment procedures.In the three years,77 strains of fungi were isolated from all kinds of samples.Susceptibility testing indicated that the resistance to ketoconazole and miconazole was higher compared with that to fluconacole and itraconazole.CONCLUSIONS Fungal infection in LRT of hospital patients is closely related with age,long stay in hospital,wide administration of broad-spectrum antibiotics,immuno-suppressants and cytotoxic drugs.The most common fungi are Aspergillus and Mucor.There is an increasing number of strains of fungi resistant to drugs,especially to azole antifungal agents.Effective counter measures should be taken without delay.

In this year,ASH annual meeting reported several new targeting therapeutic drugs for chronic lymphocytic leukemia (CLL) and a part of lymphoma.Those drugs focus on some key targets in the signal transductional pathway of B cells.Although these targeting drugs individually did not improve the complete remission rate of CLL,but several clinical trial results showed that the combination therapy of those drugs with other drugs significantly improved the efficacy of CLL,and prolonged the progression-free survival of CLL patients.Therefore,experts believe that combination therapy and sequential therapy will start a new era in the treatment of CLL.This paper will share only the latest advances in the treatment of CLL and parts of lymphoma with domestic readers.

ObjectiveTo study the diagnosis and treatment of acute focal bacterial nephritis ( AFBN). MethodsBetween 1987 and 1999, we treated 18 patients with AFBN.The diagnosis,treatment and late follow up results were studied and reviewed.13 men and 5 woman,aged 16～56 years with an average of 32 years.The left kidneys in 13 patients,the right kidneys in 4 patients and both kidneys in 1 patient were affected.All of the patients presented a fever and persistent flank pain on affected side.Ultrasound showed local enlarged renal volume and space-occupying masses with low level echoes.CT scans demonstrated focal enlargement of affected kidneys and low-density solid space-occupying lesions.CT reconstruction showed wedge-shaped masses.ResultsIn 16 of the 18 cases,the clinical symptoms and the renal mass disappeared following anti-infection treatment.2 patients required operations,with draining the abscessin for one and nephrectomy for the other one.ConclusionsEarly diagnosis and prompt treatment are essential to AFBN,early and rational anti-infection treatment is effective.

Objective　To summarize the phenotypic and genotypic characteristics of mitochondrial combined oxidative phosphorylation deficiency type 1 (COXPD1), and to improve the clinicians' awareness of this mitochondrial encephalomyopathy. Methods　The clinical characteristics, physical examination, laboratory examination and other data of a child with COXPD1 were analyzed retrospectively. The diagnosis was confirmed by clinical whole exon sequencing and high-precision mitochondrial genome full-length PLUS gene detection, and the phenotype and genotype were analyzed by reviewing relevant literature. Results　A one-year and five-month-old boy mainly presented with hyperlactacidemia and abnormal liver function. Clinical whole exon sequencing showed that the child had homozygous variation of c. 688G>A(p.G230S) in the GFM1 gene. Sanger sequencing verified that the variation was respectively inherited from the parents of the child (both were heterozygous) with the autosomal recessive inheritance pattern. The high-precision mitochondrial genome full-length PLUS detection also did not find pathogenic mutations related to clinical phenotypes. The child was diagnosed with COXPD1. After "cocktail" therapy and liver protection therapy, the patient's condition improved. Conclusions　The phenotype of COXPD1 is complicated and variable, mainly liver type and brain type. The mutation of GFM1 gene affects mitochondrial translation system function, and early gene detection is helpful for definite diagnosis.

Extramedullary plasmacytoma (EMP) is a rare tumor characterized by proliferation of monoclonal plasma cells,often occurs in the head and neck,followed by gastrointestinal and skin.Diagnosis is based on biopsy,which is the only accurate and reliable method.EMP is needed to discriminate with similar diseases.Radiotherapy is the preferred treatment method of EMP,because it has a higher radiation sensitivity.Sometime we can choose comprehensive treatment because of illness need.Hematopoietic stem cell transplantation is not as the preferred treatment option because of transplant rejection.

Acute myeloid leukemia (AML) is the most commom hematologic malignancy in adults.There are so many highlights in the 54th ASH annual meeting in the field of mechanism,diagnosis and treatment of AML.Especially many studies have identified genes close related to AML development,clones related to relapse and molecular marker for prognosis using next-generation sequencing (NGS).Minimal residual disease (MRD) assay has been used for evaluation of therapy efficacy and posttherapy prognostication in AML treatment.The tyrosine kinase inhibitor targeting FLT3-ITD in this meeting is the best highlight in the treatment of refractory and relapsed AML.

BACKGROUND:Studies have reported that puerarin can reduce bone resorption and promote bone formation. OBJECTIVE: To further explore the effects of puerarin at different doses on the proliferation of osteoblasts culturedin vitro. METHODS: Osteoblasts isolated from the cranium of newborn rats were culturedin vitro, and then passage 3 cels were cultured in DMEM medium with the presence of 0, 20, 40, 80 and 100 μmol/L puerarin+10% fetal bovine serum for 48 hours. The viability of osteoblasts, alkaline phosphatase activity and mineral node formation were determined using MTT, alkaline phosphatase kit and alizarin red staining, respectively. RESULTS AND CONCLUSION:The viability of osteoblasts treated with puerarin at either 40 or 80 μmol/L was significantly higher than that of the control group. Alkaline phosphatase activity and the number of mineral modules were significantly increased in osteoblasts cultured with puerarin at 40 or 80 μmol/L when compared with the untreated cels. These findings demonstrate that puerarin is able to promote osteoblast proliferation in vitro.