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.

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.

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 study the impacts of quercetin on alcohol-stimulated liver injury in rats.Methods Thirty Sprague-Dawley rats were randomly divided into control,model,quercetin treatment (40mg/kg,80mg/kg,160mg/kg) groups.Ethanol plus 0.5ml fish oil were used to induce alcoholic liver injury for 6 weeks.Liver injury was evaluated using pathological examination and serum ALT levels.The plasma endotoxin and serum TNF-α,IL-1 and IL-18 levels were analyzed by ELISA method.The expression of CD14,LBP,TNF-α,IL-1 and IL-18 proteins in the liver were measured by Western blot.Results The increased serum ALT,fatty degeneration,focal necrosis and inflammatory cell infiltration in the liver were investigated in model group.In addition,plasma endotoxin,serum TNF-α,IL-1,IL-18 levels,and the expression levels of CD14,LBP,TNF-α,IL-1,and IL-18 proteins significantly elevated in model group compared with control group (P ＜ 0.05).However,quercetin treatment improved histological changes,and significantly reduced the levels of plasma endotoxin and serum TNF-α,IL-1,IL-18,as well as the expression of CD14,LBP,TNF-α,IL-1 and IL-18 proteins (P all ＜ 0.05).Fatty degeneration was still investigated in quercetin treatment group,but focal necrosis and inflammatory cell infiltration disappeared.Conclusion Quercetin can protect liver against necrosis and inflammation induced by alcohol,and the mechanism may involve its effect on the reduction of plasma endotoxia,and inhibition of Kupffer cell activity and proinflammatory cytokine expression.

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.

Objective To understand the Oncomelania hupensis distribution and infection status in the schistosomiasis sur?veillance sites of Yunnan Province,so as to provide the evidence for making the control and prevention measures. Methods Eighteen administrative villages were selected as the surveillance sites where the schistosomiasis endemic was serious in 18 epi?demic counties,one village for one county. The snail status was investigated with the systematic sampling and environmental sampling methods,and the infection status of the snails was detected by a microscope and loop?mediated isothermal amplifica?tion(LAMP). The surveillance database was established and descriptively analyzed. Results In 2015,the total surveillance ar?ea was 1 826.55 hm2,and the area with snails was 55.03 hm2,that was reduced by 57.70% as compared to that in 2013,and by 40.63% as compared to that in 2014. No new snail area was discovered,and also no schistosome infected snails were discovered. Totally 718 532 frames were surveyed,and the occurrence rate of frames with snails was 0.45% and the density of living snails was 0.013 9 snail/0.1 m2. In the endemic controlled areas,the snail area and density of living snails were both the highest. The snails concentrated on the environments of paddy field,ditch,bottomland,small reservoir,and dry land,and the vegetations of rice,dry crop,weed and wood. The snail area,occurrence rate of frames with snails,total number of snails and number of liv?ing snails all showed a downward trend. No infected snails were found for three years. Conclusions The Oncomelania hupensis snails have been effectively controlled in the national schistosomiasis surveillance sites of Yunnan Province. However,the com?prehensive snail control measures still should be continually strengthened in order to consolidate the achivements.