Evans syndrome is a rare autoimmune disease.Clinical presentation are the different degrees of bleeding and hemolysis,similar to immune thrombocytopenia and autoimmune hemolytic anemia.The treatments are divided into first-line therapy,second-line therapy and third-line therapy,including corticosteroids,intravenous immunoglobulin; immunosuppressive agents,splenectomy; haemopoietic stem cell transplantation,romiplostim and so on.The treatment of refractory Evans syndrome is difficult.Immunosuppressive agents and haemopoietic stem cell transplantation are effective.This review focuses on recent developments in the treatment of Evans syndrome.

Since the current diagnostic techniques difficult to accurately distinguish the source of uric candidas between colonization and infection,making the clinical status and the value of diagnosis and treatment of candiduria were not given sufficient attention.This paper analyzes research and case reports of cadiduria both home and abroad,and the results showed that there is a close relationship between candiduria and candidemia,and candiduria has more easier initiated the invasive candidiasis than other sites colonization of candidas.So it is worth to give more clinical attention,especially for critical patients,and should be active in antifungal therapy after identified the cause of candiduria.

Human T cells can be induced to enter into G1(G1a and G1b)phase,but not into S and G2/M phases from G_0 phase by low—dose PHA(0.15?g/ml),and the low—dose PHA—activatedT cells can by induced to enter into S and G2/M phases by rIL—2.By using this system the ef-fect of the multiglycoside of Tryperygium Wilfodii Hood F.(T)on T cell proliferation has beenflowcytometrically analyzed.The data indicate that T inhibites T cell proliferation at the facetsG_0—G1a,G1a—G1b,G1—S and S-G2/M in the cell cycle.

Vasovagal syncope (VVS) is the most common cause of transient loss of consciousness ( TLOC ),mainly with head-up tilt test (HUTT) for diagnosis and treatment evaluation.Beacause of potential risks in the process of HUTT,it is necessary to explore an early,accurate,safe,effective,inexpensive and convenient means of diagnosis and evaluation for VVS.The means of quantitative history are now in practice of clinical trials.The means commonly used are Calgary Presyncope Form (CPF)and three questionaires about point scores in the Calgary syncope symptom studies.Due to its stable,simple and easy to apply features,CPF has some advantages on assessing the effectiveness of different treatment methods for VVS.The three questionnaires have some application potential in diagnosis for VVS.

Objective To explore the diagnostic value of multi-slice spiral CT MIP-MPR image in regional lymph node metastasis of colonic carcinoma.Methods CT findings of 33 cases with pathological confirmed colonic carcinoma were analyzed retrospectively . All patients were underwent three-phase 256-slice CT dynamic enhancement scanning.All data were processed in workstation,to obtain routine MPR and MIP-MPR image.The regional lymph nodes of colon cancer were counted,and divided into 3 groups accord-ing to the short diameter of lymph node:group I (3.0-5.0 mm),group Ⅱ(5.1-10 mm),and group Ⅲ(10.1 mm up).The diag-nostic sensitivity of CT MPR and MIP-MPR image in checking out lymph nodes of different groups was compared by paired test.Re-sults The average value(x ±s )of lymph node number of three groups with routine MPR and MIP-MPR image were:group I, 3.66±1.99,6.09±2.44 (t=1 1.6,P <0.05);group Ⅱ,3.72±1.79,4.03±1.89 (t=3.73,P <0.05);group Ⅲ,1.21±1.31, 1.27±1.46(t=1.44,P >0.05).There were statistical differences in group I and group Ⅱ.Sensitivity of MIP-MPR image in chec-king out regional small and middle lymph nodes of colonic carcinoma was higher than routine MPR image.Conclusion Multi-slice spiral CT MIP-MPR image is a good way to checking out regional small and middle lymph nodes of colonic carcinoma.

Thyroid hormones and the related antibodies have some function in the natural process of breast cancer development.The possible mechanisms include:iodine complex can inhibit breast cell proliferation and can induce apoptosis; thyroid hormone can affect breast cancer cell proliferation and apoptosis; the imbalance of thyroid hormone and estrogen hormone promotes breast cells cancerous; hypothyroidism may affect the proliferation and invasiveness of breast tumors; lymphocytic infiltration or abnormal local immune response in thyroid disease.

Objective To explore the surgical anesthesia in patients with schizophrenia, clinical effect of two drug combination.Methods40 cases of anesthesia for the patients with schizophrenia surgery using fentanyl combined with propofol, and classified as the control group, the other 40 patients used remifentanil combined with propofol anesthesia and the patients were classified as observation group.In our hospital from October 2016 to March 2015.ResultsComparing the two groups of patients with heart rate and blood pressure, found in the two groups had no significant difference before anesthesia after anesthesia, intervention at different time points showed corresponding differences (P<0.05) shows significant differences.Compared two groups of patients, the recovery time of the surgery, the patients in the observation group were relatively fast, comparison between groups (P<0.05) showed obvious differences.The adverse reactions in two groups were 0%, comparison between groups have no significant difference.ConclusionTwo drug combination has better effect in schizophrenia patients in surgical anesthesia, compared with fentanyl and remifentanil for anesthesia, the latter effect is better, at the same time combined treatment for patients with heart rate had little effect, conducive to the patient recovery after surgery, and no adverse reaction for patients, the drug safety, it is worthy of reference.

Objective To study MSCT findings and clinic value of hepatic abscesses on enhanced double-phase and(or)three-phase(arterial and protal venous phase and delayed phase),especially during arterial phase. Methods The MSCT imaging features of 20 cases with hepatic abscesses proved by operation or biopsy were evaluated on enhanced double-phase and(or) three-phase scan during arterial and portal venous phase and delayed phase ,especially during arterial phase.Results (1)The imaging features of aeterial phase were that the hepatic tissues around the lesions showed strong enhancement,but the lesions showed slight enhancement or not or peripheral enhancement. (2)The imaging features of protal venous phase were:a.circular target sign; b.circular sign; c.flower valve sign; d.multiloculated sign. (3)The imaging features of delayed phase were that the masses changed smaller or not and the belt disappeared or got vague. Conclusion The double-phase or three phase MSCT scan fully reflects the pathologic changes of hepatic abcesses and is very important to early diagnosis and differential diagnosis.

Objective To investigate the effectiveness of system approach to management on prenatal health care in floating population. Methods The prenatal care was managed through establishing "Contact handbook on the health of pregnant women in Shanghai" for 505 lying-in women from the floating population of Minhang District. The condition of antenatal health care, the outcome of gestation and related factors were investigated and the results were compared to those reported in literatures. Results After system approach to management, the rate of having 1 - 3 antenatal examinations accounted for 32.1% ( 162/505 ), that of 4 - 8 examinations accounted for 43.0% ( 217/505 ), that ≥ 9 examinations accounted for 15.6% (79/505), which were higher than that reported by Zhuang Chanjuan (P = 0.001 ). Among 458 responders 185 (40.4% ) thought the cost for prenatal examination was "high" or "too high". Among 293 responders, 211 (72.0%) did not establish the contact handbook due to "not knowing the handbook" or "not clear about the process". The frequency of antenatal examination was associated with education levels of the lying-in women ( P =0.000) , whether their husbands being native Shanghainese or not ( P =0.002)and establishing contact handbood ( P = 0.002). Conclusions System approach to management promotes the utilization of antenatal health care for floating population, establishing contact handbook is a workable method to promote the utilization.