Objective To analyze the clinical value of serum and cerebrospinal fluid(CSF) procalcitonin in the diagnosis of adult central nervous system(CNS) infection to provide reference for its clinical diagnosis and treatment .Methods Sixty adult patients with CNS diseases admitted to our hospital from February to December 2015 were selected as the research subjects .All patients were suspected of CNS infection at initial visiting due to suspected CNS symptoms and signs ,and the CSF pathogenic examination and separation were performed to determine the types of infected pathogenic microorganisms .Meanwhile serum and CSF procalcito-nin was detected .The detection results of CSF pathogen and procalcitonin were summarized .The detection results of CSF pathogen served as the gold standard ,serum and CSF procalcitonin> 0 .5 ng/mL as infection positive .The diagnostic test fourfold table was adopted .Then the procalcitonin detection results and CSF pathogenic microorganism detection data were inputted .The consistency of serum and CSF procalcitonin for judging CNS infection was analyzed and calculated .The sensitivity ,specificity and accuracy of serum and CSF procalcitonin detection method for detecting pathogenic microorganisms were analyzed .Results Among 60 cases ,31 cases were bacterial infection ,22 cases were viral infection and no pathogenic bacterium was detected out in 7 cases ,the positive rate was 88 .34% .In the serum procalcitonin detection :49 cases were positive and 11 cases were negative ;in CFS procalcitonin detec-tion:37 cases were positive and 23 cases were negative .The Kappa coefficients of serum procalcitonin and CFS pathogenic detection results was 0 .769 ,indicating that serum procalcitonin and CFS pathogenic detection results had higher consistency ;the Kappa coef-ficients of CSF procalcitonin and CFS pathogenic detection results was 0 .315 ,indicating that CFS procalcitonin and CFS pathogenic detection results had poor consistency .The sensitivity ,accuracy and specificity of serum procalcitonin for diagnosing CNS infection were 96 .08% ,93 .33% and 77 .78% respectively ,which of CSF procalcitonin were 73 .33% ,45 .00% and 38 .46% respectively ;se-rum procalcitonin detection had a higher clinical value in the diagnosis of adult CNS infection ,while CSF procalcitonin detection had little value .Conclusion The serum procalcitonin detection method has higher sensitivity ,accuracy and specificity for the diagnosis of adult CNS infection ,possesses a better guidance role in selecting the treatment scheme and evaluating the curative effect ,and has higher clinical value in adult patients with CNS bacterial infection .

Adolescent ; Adult ; Amanita ; Chemical and Drug Induced Liver Injury ; etiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Mushroom Poisoning ; therapy ; Retrospective Studies ; Young Adult

Objective:To analyze the rationality of off-label drug use in nephritic syndrome prescriptions to provide scientific basis for clinical rational drug use and further regulate the off-label drug use in our hospital. Methods:Totally 1 908 outpatient prescriptions of nephritic syndrome selected from our hospital during November 2014 to April 2015 were analyzed, and all the off-label drugs were listed . The rationality of the off-label drug use was analyzed and evaluated by searching the related kidney disease guidelines and litera-tures. Results:The off-label drug use of tacrolimus capsules, mycophenolate mofetil capsules, cyclophosphamide for injection, ciclos-porin soft capsules, dipyridamole tablets, hydroxychloroquine sulfate tablets and warfarin sodium tablets were recommended by domes-tic and overseas guidelines with better evidence of evidence-based medicines. Tripterygium glycosides tablets and leflunomide tablets were supported by the literatures on clinical studies at home and abroad. The above 9 kinds of off-label drugs were rational drug use. Lumbrokinase enteric-coated capsules, salvia miltiorrhiza and ligustrazine injection and pidotimod dispersible tablets were reported only by a handful of journals. Bacteria lysate capsules and boric acid powder had no related information support, which belonged to the em-pirical prescriptions of physicians. The above 5 kinds of off-label drugs were not rational drug use. Conclusion:It is a widely existing phenomenon that the medication in nephrotic syndrome is beyond the instruction, the most of off-label drug use are reasonable, and cli-nicians should prescribe medicines carefully. Our hospital needs to further standardize the management of off-label drug use supported by higher evidence in order to improve the level of clinical rational drug use and the reasonable rate of prescriptions.

We discuss the common complications and risk of rehabilitation method tor patients with common neoplasms. The matters that should be noticed in exercise therapy was considered we also investigated inteventions for these complications.

In the article we described a case of 61-year-old male with pharyngeal paraesthesia for 3 months. Physical examination: lean physique; vast uneven white membrane above hard palate, soft palate and pharynx mucous membrane, not easy to wipe and extend to the throat. The neck without cervical lymph node enlargement. Blood routine test: WBC 4.92 x 10(9)/L, N 64.3%, L 18.7%, EO 7.1%. RBC 4.08 x 10(12)/L, PLT 181 x 10(9)/L. No significant abnormal in the other blood biochemical indexes, tumor marker and immune indexes; blood bacteria culture: negative; blood culture: negative; sputum culture (3 times): all negative; anti-HIV screening test: positive, serum HIV testing: positive(the test done by Shanghai Pudong new area's centers for disease control and detection). The incidence of HIV/AIDS is still low at present, so the diagnosis of HIV/AIDS can be ignored easily by the otolaryngology doctor. If the patient with oral cavity and pharyngeal ulcer delayed healing, the doctor should be alert to,HIV/AIDS infection. We should check serum HIV antibody to eliminate or confirm HIV/AIDS earlier.
HIV Infections ; diagnosis ; Humans ; Male ; Middle Aged ; Otolaryngology ; methods

[Adstract] Micro-lecture, as the main teaching form of MOOC and SPOC network teaching platform, is deeply welcomed by the majority of students. Pathology is the bridge connecting basic medicine and clin-ical medicine in medical education, which has such characteristics as many knowledge points, dispersion and obscurity, etc. Therefore, the production of micro courses is based on the knowledge points, and according to the characteristics of the knowledge points, it should also be applied reasonably according to the charac-teristics of each chapter. Adopting the teaching of self-study after class and teachers and students' discussion in class for micro courses can not only greatly improve the quality of teaching, but also develop the students' ability of independent thinking and the ability to analyze and solve problems, which transforms the teaching of pathology from pure knowledge to ability.

To breed a new yam cultivar of Dioscorea alata, the different and excellent germplasm resources were investigated within artificially cultivated population and some superior individuals, with a higher yield and medicinal properties, were selected. Considering results of the yield and medicinal properties during 2006-2013 cropping season, strains and lines were established and selected. As a result, the yield of the new developed cultivar (Wenshanyao No. 1, WSY01-1) reached 2217. 0 kg per 667 m2 (fresh weight) and 348.3 kg per 667 m2 (dry weight), and increased 23.8% and 23.9% comparing with control cultivars (landraces). Comparing with control cultivars, the level of polysaccharide, allantoin, and dioscin increased 36.9%, 48.3%, 20.9%, and reached 12.2%, 1.30%, 579.7 µg · g(-1), respectively. This result showed that the systematic selection method can significantly improve yield and medicinal properties of D. alata, and the developed " Wenshanyao No. 1" exhibits wide spreading prospects.
Allantoin ; analysis ; Breeding ; Dioscorea ; chemistry ; genetics ; growth & development ; Diosgenin ; analogs & derivatives ; analysis ; Polysaccharides ; analysis

Holistic education is an important philosophy of medical education.Medical graduate students can show their skills of medical specialties,improve their abilities of communication and cooperation,and promote their sense of social responsibility through social practice.Through conducting questionnaire among medical graduate students of Peking University Third Hospital who major in internal medicine,we have got to know the effect of social practice on holistic education philosophy.Meanwhile,social practice is a crucial approach to implementing holistic education.

Objective To explore the value of Ligasure vessel sealing system(LVSS)during resection of retroperitoneal tumor.Methods Group 1 including 32 cases were performed resection of retroperitoneal tumor with LVSS and electrosurgical seapel from Jun.2004 to Oct.2008.group 2 including 26 cases were done with electrosurgieal seapel from Jan.2001 to Jun.2004.Operating blood loss,operating time,iatrogenic injury,postoperative blood loss and hospital stay were compared between the two groups.Results There was no significant difference in hospital stay[(11.7±0.7)d vs.(12.3±1.4)d)]and iatrogenic injury(9.38%vs.16.00%)between two groups statistically(P＞0.05),but the intraoperative blood lose[(403.1±37.1)ml vs.(704.0±129.0)m1)s,postoperative blood loss[(131.5±18.4)ml vs.(214.8±29.2)ml)]and operating time[(166.5±8.9)min vs.(186.8±15.4)min]were less in group 1 than that in group 2(P＜0.05).Conclusion Ligasure vessel sealing system has advantages of safe coagulation,shortening operation time in resection of retroperitoneal tumor.

Objective To investigate the impact of different kinds of laparoscopic surgery including conventional blunt elimination and modified acute elimination on sex hormone, antral follicle count and ovarian volume of patients with endometriosis (EMs). Methods 100 patients with EMs were chosen from January 2013 to April 2016 and randomly divided into control group (50 patients) with conventional blunt elimination and observation group (50 patients) with modified acute elimination; and the thickness of elimination lesion, the removal rate of ovary cortex, the thickness of ovarian cortex, the level of serum sex hormones, the AFC number of affected side and the volume of ovary before and after operation of the two groups were compared. Results There was no significant difference in the thickness of lesion elimination, the removal rate and removed thickness of ovarian cortical between the two groups (P > 0.05). The thickness of lesion elimination and the thickness of ovarian cortex in middle position of observation group were significantly lower than that in control group (P < 0.05). The thickness of lesion elimination, removed thickness of ovarian cortical and the removal rate of ovary cortex in hilus ovarii in observation group were significantly lower than that in control group (P < 0.05). There was no significant difference in the levels of serum sex hormones before and after treatment between the two groups (P > 0.05). There was no significant difference in the levels of AFC number of affected side before and after treatment (P > 0.05). The levels of AFC number of affected side in hilus ovarii of control group after treatment were significantly lower than that before treatment (P < 0.05). The volume of ovary of both groups after treatment were significantly lower than that before treatment (P < 0.05). The volume of ovary of observation group after treatment were significantly higher than that in control group (P < 0.05). Conclusion Compared with conventional blunt elimination, modified acute elimination in the treatment of patients with EMs can efficiently shorten the operation time, reduce the surgical trauma degree, speed up the recovery process after operation, regulate the level of FSH and AMH and be helpful to protect the ovarian reserve function.