Objective To discuss the detection value of(1,3)-β-D -glucan in the early diagnosis of fun-gal infection in clinic.Methods 86 patients with deep fungal infection were selected as the study group,and 24 cases of healthy volunteers were selected as the control group,all groups took plasma G test,while cultivating specimens sus-pected infection and deep fungal infections in patients were divided according to culture -negative group and positive group,plasma G test results were compared.Results In the control group,G test was (6.12 ±2.87)×10 -3 ng/mL in plasma,deep fungal infection negative,positive test results were (32.58 ±24.12)×10 -3 ng/mL and (101.28 ± 36.04)×10 -3 ng/mL in plasma G respectively,positive group G results in plasma were significantly increased,the differences were statistically significant(t =18.28,7.92,P =0.036,0.042);both positive plasma G test results were significantly higher than that of the negative group,the difference was statistically significant(t =12.16,P =0.038). Plasma G test positive diagnosis of deep fungal infection was 79.1%,significantly better than the fungal culture 50.0%,the difference was statistically significant(χ2 =31.26,P =0.002).Conclusion In early clinical diagnosis of deep true infection,plasma G test positive rate is higher than fungal culture,and is worthy of wider application.

Objective To discuss the clinical value of plasma (1,3)-β-D -glucan detection (G test) for early diagnosis of invasive fungal infections (IFI).Methods A total of 180 cases of IFI were divided into suspec-ted group (84 cases),diagnosed group (49 cases)and clinical diagnosis group (47 cases).At the same period,the other 44 hospitalization patients with bacterial infection and 53 healthy persons were selected.All personnel were par-ticipated in the experiment using the MB -80 system for rapid detection of microbial dynamic detection,simultaneous plasma G test was evaluated using ROC curve analysis G optimal threshold test.Results Candida albicans was a common respiratory infections of IFI.Compared with bacterial group (9.4pg/mL)and normal group (7.8pg/mL) plasma glucan content median,IFI group plasma G test (29.3pg/mL)was significantly higher,and the differences were statistically significant(Z =-2.41,P =0.015;Z =-2.19,P =0.028),Compared with the median plasma glu-can content of the diagnosis group (105.8pg/mL)and clinical diagnosis group (46.3pg/mL),to be diagnosed group (8.1pg/mL)was significantly lower,and the differences were statistically significant(Z =-2.99,P =0.003;Z =-2.19,P =0.027).ROC curve analysis showed that when the cutoff value was 9.35pg/mL,its specificity (67.2%), sensitivity (70.3%)and negative /positive predictive value (69.3% /65.8%)were the best,and more consistent with the culture method,the Kappa value was 0.603,the difference was statistically significant (P =0.036 ). Conclusion In the early diagnosis of IFI,plasma G test has good results and can be widely used.

Prader-Willi syndrome (PWS) is a multisystemic complex genetic disorder caused by the lack of expression of genes associated with the 15q11.2-q13 region of the paternal chromosome.There are three main types of genetic mechanisms, deletion of the paternal critical region, maternal uniparental disomy and imprinting center defect.Genetic counseling can be carried out based on different genetic mechanisms of PWS, both re-fertility assessments and prenatal diagnoses were performed on couples whose children have already had the disease.The pathogeny and mechanism of PWS are complex.The rapid development of molecular genetics and related research have provided a basis for further understanding of this disease.In this paper, the advances in the genetics of PWS were reviewed.

Objective:To explore the association between the CYP21A2 genotype and the virilization severity in girls with classic 21-hydroxylase deficiency (21-OHD), so as to further the understanding of virilization in females and provide guidance for prenatal diagnosis and genetic counseling. Methods:A total of 23 patients with two X chromosomes (46, XX) who were newly diagnosed with classic 21-OHD in Wuhan Children′s Hospital from August 2010 to March 2019 were included.These patients were divided into 3 groups according to the Prader grades of the degree of external genitalia masculinization.The 17-hydroxyprogesterone (17-OHP) level, androstenedione (AND) level, testosterone (T) level, dehydroepiandrosterone sulphate (DHEAS) level and genotypes were recorded.The gene mutations were divided into the Null group(the enzyme activity was completely impaired), group A(1% of the normal enzyme activity was retained), group B(2% of the normal enzyme activity was retained) and group C(20%-60% of the normal enzyme activity was retained). The correlation between the gene variation of different Prader grades and the corresponding gene groups were analyzed.Results:All 23 girls showed different degrees of external genitalia masculi-nization.There was a significant positive correlation between the Prader grades and the type of gene variation ( rs=0.696, P<0.001). The gene group A and Null group were highly matched with the Prader Ⅳ(the matching rate: 77.8%). Eighty percent of girls with Prader Ⅱ and Prader Ⅲ were classified as the gene group B. The testosterone le-vel of girls with Prader Ⅳ at first diagnosis was significantly higher than that of girls with Prader Ⅱ [4.6(4.0, 15.0)μg/L vs.0.63(0.40, 1.39)μg/L]( χ2=15.117, P<0.05). Conclusions:There is a significantly positive and strong correlation between the degree of external genitalia masculinization and the degree of deficiency of enzyme activity caused by gene variation in girls with typical 21-OHD.It can provide reference for both parents carrying CYP21A2 gene in prenatal diagnosis, genetic counseling and individualized diagnosis and treatment.

This article reviews and summarizes the research data about vertebrobasilar dolichoectasia in recent years from the aspects of epidemiology,pathogeny,pathology,diagnosis,clinical manifestations,as well as its mechanism and treatment.

Objective To check the maneuverability of the nursing safety management indicators for skilled nursing facilities.Methods A hospital based skilled nursing facility in Chongqing was chosen as the main study target while a Red Cross nursing hospital in Shanghai which operated earlier was also included as a comparison object.Combination of files reference,on-the-scene observation,manager interviews,sampling survey and institution's self-assessment,scores of indicators were calculated,and the total scores for both institutions were calculated as well.Results The institution from Chongqing marked 81 points while the other one got 86 points.Conclusions The indicator system had good maneuverability and the weight of indexes was consistent with the practical requirement of safety management.This indicator system could provide reference for standardize skilled nursing facilities' management,but still needed further revision and consummation.

Objective To investigate the safety of tanshinone Ⅱ A sodium sulfonate in treatment of acute cerebral hemorrhage.Methods One hundred and seventy-two patients with acute cerebral hemorrhage were divided into tanshinone treatment group with 84 cases (tanshinone Ⅱ A sodium sulfonate + traditional treatment) and traditional treatment group with 88 cases (traditional treatment) according to the method of treatment.The safety (including neural function defect,adverse reactions,rebleeding rate and mortality and so on) were determined before treatment,and 2,4 weeks after treatment.Results The chinese stroke scale (CSS) scores in tanshinone treatment group after treatment of 2,4 weeks were lower than those in traditional treatment group [(13.2 ± 4.3) scores vs.(17.4 ± 5.6) scores,(8.7 ± 3.5) scores vs.(12.8 ± 4.6) scores],there were significant differences (t =5.498,6.556,P ＜ 0.01).The total effective rate in tanshinone treatment group was significantly higher than that in treatment group [83.3 ％ (70/84) vs.65.9 ％ (58/88)],there was significant difference (x2 =6.854,P ＜ 0.01).After treatment with tanshinone Ⅱ A sodium sulfonate in tanshinone treatment group,5 cases of mild skin rash,3 cases of nausea,vomiting,to turn for the better after symptomatic treatment.There was not other adverse reactions in the observation period.The mortality,rebleeding rate in tanshinone treatment group were lower than those in traditional treatment group,but there were no significant differences (P ＞ 0.05).Conclusions Early application of tanshinone Ⅱ A sulfonate treatment in acute cerebral hemorrhage has significantly efficacy,in the process of the clinical application is safe amd reliable.It is worthy of clinical popularization.

Objective To explore the dynamic responses of Sertoli cells to depletion of spermatogonial stem cells by busulfan.Methods After intraperitoneal injection of 15, 30 or 44 mg/kg busulfan to mice, the spermatogenesis and the expression of GDNF, PLZF, Nanog and GFRɑ1 mRNA were assessed by real-time quantitative PCR at 5 and 28 days after the busulfan treatment.Results Glial cell line-derived neutrophic factor ( GDNF ) was significantly increased and showed a dose-dependent trend at 5 days after busulfan treatment, but no significant difference was seen in the expression of promyelocytic leukemia zinc finger(PLZF) and GDNF family receptorα-1(GFRα1).The testicular histology also appeared no significant difference at 5 days after busulfan treatment.At 28 days after busulfan treatment, the relative expression lev-els of GDNF, PLZF, Nanog and GFRɑ1 mRNA were drastically increased.Morphological observation showed that spermat-ogenesis damages became even more severe as the busulfan dose increased.Conclusions Sertoli cell response to the de-pletion of spermatogonia occurs as early as the fifth day after busulfan treatment.Production of GDNF in Sertoli cells shows a compensatory increase, which may stimulate spermatogonial stem cells to accelerate their self-renewal, reflected by the enhancing expression of Nanog and PLZF, and ultimately promote the restoration of spermatogenesis.

Objective To investigate Helicobacter pylori(Hp)infection and HLA-DQA1 allelic frequency in family members of children with recurrent abdominal pain.Methods One hundred and eighteen family members of 20 children with recurrent abdominal pain were divided into two groups:with and without recurrent abdominal pain.Serum Hp antibody was tested by dot immunogold filtration assay and immunophenotyping was determined by Western blot(immunobiot)technique.Polymerase chain reactionsequence specific primers(PCR-SSP)technique Was applied to identify HLA-DQAi allelic frequencies.Hardy-Weinberg equilibrium test was performed(P>0.05),and Chi-square test was used to compare the frequency of HLA-DQA1 alleles between the groups.Results The Hp seropositive rate in 118 members Was 100%and the Hp immunophenotyping was 96.6%.The prevalence of Hp Ⅰ and Ⅱ type was 55.1%(65/118)and41.5%(49/118).HLA-DQA1*0302 allelic frequency Was significantly higher in subjects with recurrent abdominal pain than that in subjects without one(23%vs.2%,X2=13.277,P=0.000).Conclusion There is immunogenetic difference between familial members with and without recurrent abdominal pain infected by Hp,and HLA-DQA1*0302 may be the associated gene contributing to different clinical outcomes after Hp infections.

The liver is closely associated with the kidney, and liver injury in various stages can cause various kidney diseases to varying degrees, which further lead to renal impairment. Such renal impairment in the early stage is often functional and can be reversed by drugs, otherwise it can progress to hepatorenal syndrome, cause acute renal failure, and even threaten human life. The indicators such as serum creatinine and urea nitrogen have a limited effect in the early diagnosis of renal impairment and cannot be used for early monitoring and diagnosis of liver cirrhosis patients with renal impairment. Therefore, early monitoring of liver cirrhosis patients with renal impairment has always been a hot topic in this field. This article summarizes the research advances in the indicators for early diagnosis of renal impairment.