Objective To assess the diagnostic value of Wells score and D-Dimer detection in acute pulmonary embolism. Methods Forty-two suspected cases of pulmonary embolism were collected from March 2012 to September 2014 Then Wells score and D-Dimer detection were applied to confirm the disease. Results Of the total, 26 patients were diagnosed by computed tomographic pulmonary arteriography (CTPA). There were 7, 24 and 11 suspected cases which had low, medium and high Wells score respectively. Among them, 1, 15, and 10 cases were diagnosed by CTPA. The diagnosis rates were 14.2% (1/7), 62.5% (15/24) and 90.9%(10/11) respectively. The D-Dimer level in pulmonary embolism group was significantly higher than that in non-embolism group(P < 0.01). The D-Dimer level of cases with medium or high Wells score was higher than those with low Wells score (P < 0.05). Conclusion Wells score combined with D-Dimer is convenient, accurate and safe for predicting acute pulmonary embolism.

Objective To summarize the hot spots and cutting-edges by exploring Multidisciplinary Team (MDT) research in cancer.Methods CiteSpace is used to analyze MDT in cancer visually.Results 2 160 related literatures,10 key literatures,15 main clusters and 29 burst terms are detected.Conclusion MDT research on cancer mainly focuses on operation process,implemention and evaluation of effects.Improving efficiency,cost-effectiveness analysis and randomized controlled trial is the cutting-edge topics.This provides a new perspective for China.

Object To search for bioactive secondary metabolites from marine organisms, the marine sponge Cinachyrella australiensis was collected from Hainan Island, Southern China Sea to develop the efficient drug for human beings. Methods Silic gel flash chromatography in association with reverse phase semipreparative HPLC was performed for the isolation and purification of the ethanol extracts, and extensive spectroscopy including 2D NMR spectra as well as the comparison of the spectral data with those reported in literatures was applied for the structure elucidation. Results Seven nucleotidoids were isolated and identified. They are named as 2-methyl-6-amino-9-(2-deoxy-?-D-ribofuranosyl)-purine (Ⅰ), 2′-deoxyadenosne (Ⅱ), 6-amino-9-?-D-ribofuranosyl-9H-punne (Ⅲ), uracill (Ⅳ), thymine (Ⅴ), thymidine (Ⅵ), 1-(2-deoxy-?-D-ribofuranosyl) uracil (Ⅶ). Conclusion The sponge C. australiensis is systemically separated, and then two kinds of nucleotidoids compound are extracted.

Objective:To investigate the chemical constituents from Avicennia marina.Methods:The isolation and purification of the CH2Cl2 and n-BuOH fractions of this plant were performed,and the chemical structures were elucidated by spectral analysis as well as comparison of their spectral data with literature values.Results:Three novel compounds were obtained and identified as erythro-guaiacylglycerol-?-ferulic acid ether(1),marinnone A(16) and marinnone B(17),along with eighteen known compounds as threo-guaiacylglycerol-?-ferulic acid ether(2),eleutheroside E2(3),(+)-lirioresinol A(4),dihydroxymethyl-bis(3,5-dimethoxy-4-hydroxyphenyl) tetrahydrofuran-9-O-?-glucopyranoside(5),(+)-lyoniresinol 3a-O-?-D-glucopyranoside(6),(-)-lyoniresinol 3a-O-?-D-glucopyranoside(7),epi-pinoresinol(8),leucoseceptoside A(9),jionoside C(10),salsaside A(11),ilicifolioside A(12),acteoside(13),isoacteoside(14),ethyl ferulate(15),avicennone D(18),avicenone E(19),avicennol C(20),and stenocarpoquinone B(21).Conclusion:Three new compounds(1,16 and 17) were obtained and thirteen known compounds,2-12,14 and 15 were isolated from Avicennia genus for the first time.

Objective To analyze the distribution characteristics and risk factors of extended stay over 30 days at tertiary comprehensive hospitals, and explore methods of shortening average length of stay(LOS).Methods Homepage of all inpatients discharged from October 2014 to October 2015 of 31 tertiary comprehensive hospitals in Shanxi province were collected.39 234 cases of these inpatients stayed over 30 days and their case information was complete.A generalized linear model was used for risk factors analysis.Results With the extension of LOS, most of the inpatients with extended stay were found during their 30th-40th days, accounting for 50.21% of all and constituting the highest daily costs as well.The ratio of inpatients decreases with their LOS, and its distribution presents a positive skew in entirety.Distribution of inpatients over 30 days identified urban employees under medical insurance accounting for the highest ratio among all payment categories,and those from the department of orthopedics for the highest ratio among all departments, while those of diseases from injury and poisoning accounting for the highest ratio among all disease categories.The findings indicated ten important factors for extended stay, namely gender, medical payment category, ICD, inter-department transfer, nosocomial infection, and clinical pathway.Conclusions To strengthen management of specific departments and inpatients, focus on key process of medical quality, and accelerate medical insurance payment reform can effectively control extended stay.

Objective To investigate the clinical features,diagnosis and treatment of pure redcell aplasia cased by human parvovirus B19 infection after renal transplantation.Method The clinical data including clinical symptoms and physical signs,laboratory and pathological examinations and outcomes of treatment in 8 cases at our hospital from Aug.2011 to Mar.2012 were analyzed retrospective,and relative literatures were reviewd.Result Pure red-cell aplasia occurred in all 8 cases 1 to 3 months after kidney transplantation,and one case had recurremt pure red-cell aplasia.The manifestations including recurrent reduction of hemoglobin,and pure red-cell aplasia was definitely diagnosed by bone marrow morphology,pathology,and polymerase chain reaction assay PVB19 DNA.Treatment of intravenous immunoglobulin and conversion of tacrolimus into ciclosporin was effective.Conclusion PVB19 is a rare but clinically significant infection that manifests as pure red cell aplasia during the early post-transplantation.Treatment of intravenous immunoglobulin and conversion of tacrolimus into ciclosporin in most cases was effective.

Objective To analyze the occurrence of clinical adverse drug reaction (ADR) of tonic Chinese medicinal herbs. Methods Articles about ADR of tonic Chinese medicinal herbs reported from January 1990 to February 2014 were collected from databases of CNKI, VIP, CBM, Pubmed and Embase according to incorporation and exclusion standard. Metrology analysis was also conducted. Results Totally 378 effective articles showed tonic Chinese medicinal herbs most likely to induce ADR were as follows:individual Chinese medicinal herbs including Polygoni Multiflori Radix, Ginseng Radix et Rhizoma, Lycii Fructus and Astragali Radix;injection containing Shenmai Injection, Shengmai Injection and Acanthopanax Injection;other herbal preparation covering Polygoni Multiflori tablets. The most common ADR involved the damage on skin tissue, nervous system and digestive system, with prominent relevant clinical symptoms such as itching, skin rash, dizziness, unconsciousness, nausea, vomiting, and liver dysfunction. Conclusion Correct understanding adverse reaction of tonic Chinese medicinal herbs will be conducive to rational drug use and avoiding risk.

Objective To investigate the dynamic changes of microglial polarization at the perihe-matoma area and provide timepoint evidence for interventing microglial polarization as well as studying the polarization mechanism after intracerebral hemorrhage ( ICH ) . Methods Healthy male Sprague Dawley (SD) rats were randomly divided into sham group,ICH-4 h,1 d,3 d,7 d and 14 d groups with 6 in each group. The rats in ICH groups were injected collagenase VII-s into the caudate nucleus to establish the in-tracerebral hematoma model and rats in sham operated group were treated with the same amount of saline. The brains were taken at 4 h,1 d,3 d,7 d,14 d in the ICH group,1 d in sham group. Microglia typeⅠ( M1, CD11b++CD86+) and microglia typeⅡ( M2,CD11b++Arg-1+) were examined by immunofluorescence and the number of M1 and M2 around hematoma were analyzed. Results ( 1) The M1 and M2 were both ob-served at 4 h after ICH and a small quantity of branches were still presented on M1. ( 2) M1 took the main position in acute stage (1~3 d),early subacute stage(3~7 d) and chronic stage (>14 d) after ICH.The number of M2 was elevated transiently in superacute (<24 h) and late subacute stage (7 d).The number of M2 (31.40±1.69) was more than M1 (21.43±1.81) at 4 h after ICH ( t=- 4.085, P=0.002),and the number of M2 (116.25±5.06) significantly exceeded M1 (85.75±7.32) again on day 7 ( t=-0.690, P=0.001). Conclusion M1 is in a dominant position in acute,early subacute and chronic stages after ICH;M2 is dominant in superacute and late subacute stages. Investigating the mechanism of M2 formation at acute period ( such as 4 h) or late subacute stage ( such as 7 d) ,and inhibiting M1 formation in the early subacute stage ( 1~3 d) have important significance for clinical treatment of ICH.

Objective To evaluate the relationship between polymorphisms in surfactant protein (SP) genes and susceptibility to chronic obstructive pulmonary disease (COPD). Methods An extensive literature search for relevant studies was conducted in databases of Wanfang Data, VIP, Google Scholar, PubMed, CNKI, CBM, EMBASE and Web of Science and so on from inception to Sep., 2013. A meta-analysis was then performed using Stata 12.0 software. Results 7 case-control studies were included with a total of 1,279 COPD cases and 1,482 healthy controls. This meta-analysis revealed that polymorphisms of the SP-A gene might be associated with an increased risk of COPD (allele model: OR=1.53, 95%CI: 1.14~2.05, P=0.005; dominant model: OR=1.65, 95%CI: 1.02~2.69, P=0.043; recessive model: OR=1.66,95%CI: 1.17~2.35, P=0.005: homozygous model: OR=2.06, 95%CI: 1.24~3.41, P=0.005; eterozygous model: OR =1.59, 95%CI: 1.13~2.22, P=0.007; respectively). However, there was no evidence for any association between polymorphisms of the SP-B and SP-D genes and COPD risk (all P>0.05). Further subgroup analysis by ethnicity suggested that SP-A genetic polymorphisms were associated with an increased risk of COPD among Asians, but not among Caucasians. Conclusion SP-A genetic polymorphisms may contribute to increasing susceptibility to COPD, especially among Asians.

OBJECTIVE: Nasopharyngeal Carcinoma (NPC) can be successfully treated by radiotherapy, if the tumor is confined to nasopharynx, but clinical onset is usually delayed to more advanced stages, when prognosis is poor. The objective is to determine efficacy of a new program for early NPC detection, which entails stratification of the NPC risk of target population according to serum levels of 3 Epstein Barr Virus (EBV) antibodies. METHOD: The sera of 1373 healthy adult residents from Zhongshan were collected and analyzed in this study from Mar 16, 2007 to Dec 31, 2007. The levels of EBNA1/IgA, zta/IgG and EBNA1/IgG were tested by ELISA. To stratify the subjects of 1373 adults into high, moderate and normal NPC risk groups by regression analysis of the levels of the EBV antibody. The high-risk groups of nasopharyngeal carcinoma risk could be followed-up every 3-6 month. RESULT: NPC risk of 1379 adults was stratified according to serum levels of the 3 EBV antibodies. Eleven (0.8%) were identified to be of high risk for NPC, having high levels of all three antibodies and/or IgA EBNA level > 3 rod. Clinical examination of high risk subjects detected 5 NPC cases, 3 cases detected in the first instance and 2 in follow-up examination 3 to 6 months hence. Three cases were diagnosed with UICC Stage I tumor (60%), one in the first instance and 2 in follow-up, and the 5 cases account for all NPC cases detected from the entire cohort over 28 months(100%). CONCLUSION The new program affords an efficient and efficacious means for early NPC detection.
Antibodies, Viral ; blood ; China ; epidemiology ; Early Detection of Cancer ; methods ; Epstein-Barr Virus Nuclear Antigens ; immunology ; Humans ; Male ; Middle Aged ; Multiphasic Screening ; Nasopharyngeal Neoplasms ; blood ; diagnosis ; epidemiology ; virology ; Risk Assessment