We describe a 58-years-old man with a primary nasopharyngeal carcinoma accompanying erythroderma. His first symptoms were systemic scattered erythema and itching for six months. Lower right cervical lymphadenectasis was found by physical examination. A neoplasm in nasopharynx could be seen with nasal endoscope. The pathology of the neoplasm was non-keratinizing carcinoma. This case illustrates that "erythroderma" could be a paraneoplastic effect of nasopharyngeal carcinoma.
Carcinoma ; Dermatitis, Exfoliative ; complications ; Humans ; Male ; Middle Aged ; Nasopharyngeal Carcinoma ; Nasopharyngeal Neoplasms ; complications ; Paraneoplastic Endocrine Syndromes ; complications

[Objective]To analyze the MRI and CT characteristics of the pathological changes of ligamentum flavum.[Method]Clinical data of MRI and CT characteristics of 48 cases of lagamentum flavum pathological changes were analyzed and compared retrospectively.[Result]MRI showed"\"signal in sagital position and"V"signal from the vertebral canal in stalk postition.CT showed two sides of soft tissue signal of vertebral canal and some part presented bone substance density.[Conclusion]The MRI,CT images of the ligamentum flavum pathological changes have both advantages and disadvantages.It would benefit the clinical therapy only with the combination of them.

Objective To investigate the effect of high-flux hemodialysis on mineral and bone metabo-lism( MBD) in diabetic kidney disease patients with maintenance hemodialysis .Methods 60 cases with diabetic kidney disease undergoing maintenance hemodialysis were studied and they were randomly divided into two groups according to the number table method .Patients in each group were treated using either high-flux dialyzer or low-flux dialyzer for 6 months.Blood calcium(Ca), blood phosphorus(P), calcium*phosphorus(Ca*P), alkaline phosphatase(AKP), parathyroid hormone(PTH), and 25 hydroxy vitamin D3(25-OH-D3),etc were deter-mined at the start and end of the study .Results In high flux dialysis group , serum P, serum Ca*P, and PTH levels was(1.52 ±0.50)mmol/L,(3.05 ±1.19)pg/L and(368.61 ±235.32)pg/L respectively, which was sig-nificantly decreased than before treatment ((1.78 ±0.55)mmol/L,(3.94 ±1.31),(427.45 ±288.93)pg/L) (P<0.05), while serum Ca, and 25-OH-D3 levels were(2.3 ±0.16)mmol/L and(21.64 ±8.51)nmol/L respectively, which were increased significantly than before treatment ((2.12 ±0.18)mmol/L,(16.77 ±7.69) nmol/L)(P<0.05), yet in low flux dialysis group serum Ca, P, AKP, PTH, and 25-OH-D3 didn't change sig-nificantly before and after treatment ( P>0.05) .Conclusion High-flux dialyser provides a better effect on MBD for patients with diabetic kidney disease undergoing maintenance hemodialysis .

Objective To facilitate standing and walking after rehabilitation training by designing and using individualized ischial weight bearing orthosis for patients with various conditions of the lower limbs. Methods An orthosis with ischial support was ordered and tailored according to the condition of the patient's affected lower limb. Adaptive standing and walking training were administered daily. The functional recovery after the assembly of the orthosis was observed. Results The patients' standing and walking ability improved significantly after the training with the ischial weight bearing orthosis. The standing time was significantly longer than without the orthosis, and the walking distance was notably increased. Conclusion An ischial weight bearing orthosis has a significant effect on the recovery of standing and walking capability.

Objective To evaluate the potential effects of RS504393, CC chemokine receptor (CCR) 2b and CCR1 antagonist, on LPS-induced acute lung injury (ALI) and to investigate the underlying mechanisms. Method A549 cell line was stimulated with LPS (10 μg/mL) and then treated with RS504393 (10 μg/mL) for 6 hours. ALI model was established with intranasal administration of LPS (5 mg/kg) in C57BL/6J mice. RS504393 (5 mg/kg) was administered 30 min before LPS dripped nasally. IL-8, IL-1β, plasminogen activator inhibitor (PAI)-l,monocyte chemoattractant protein (MCP)-2,and the expressions of CCR1 and CCR2b were studied by using Realtime-RT-PCR, ELISA and cyto-flowmetry. Results In A549 cell line treated with RS504393,the expressions of CCR1, CCR2b and IL-8 were significantly inhibited after LPS stimulation. In rats with LPS-induced ALI, treatment with RS504393 significantly protected mice against lung injury by attenuating influx of leukocytes and protein into bronchoalveolar space and by lessening pathological changes of lung. Treatment with RS504393 down-regulated IL-1β and PAI-1 expressions in bronchoal veolar lavage fluid (BALF) and lungs at mRNA and protein levels along with up-regulation MCP-2 expression compared to rats of vehicle-treated groups. Conclusions CCR2b and CCR1 play pivotal roles in the development of ALl,and RS504393 as a antagonist can halt the development of ALI.

Objective To explore the medication closed-loop management of huangshi central hospital based on electronic medical records.Methods Diversified pharmaceutical information platform was constructed.The full coverage of all aspects of medication information,such as ordering/prescribing,transcribing,distributing,preparing,dispensing,administering,documenting,and monitoring was realized.Results The medication management and use had no information gap,and bias could be controlled to form a closed-loop management.Conclusion Application of the new information technology in the field of pharmaceutical care can improve work efficiency,reduce medication errors,broaden the vision of clinical pharmacists and scope of work,and improve the overall level of pharmaceutical care.

Objective To investigate the clinical efficacy and safety of the cytokine-induced killer cells (CIK) treated in patients with advanced pancreatic cancer. Methods 74 cases (hospitalized from January 2012 to December 2013) with advanced pancreatic cancer (Ⅲ ~ Ⅳ stage) were selected. The patients were randomly divided into two groups: CIK cells treated group (38 patients) and chemotherapy group (36 cases). Patients in CIK cells group received CIK cell infusion therapy , and patients in chemotherapy group received only gemcitabine. The efficacy and safety of all patients were observed. Results The efficacy rate of CIK cells group was 29.0%, with no statistical significance compared to chemotherapy alone group (16.7%). Disease control rate was 63.2%, with statistical significance compared to the chemotherapy group (38.9%). The PFS was 3 months (95%CI:2.5 ~ 3.5), OS 6.8 months (95%CI:6.1 ~ 7.5). 6-month survival rate 41.7%, with statistically significance compared to chemotherapy group. Conclusion CIK cells treated in patients with advanced pancreatic cancer is feasible and safe , and can improve disease control rate , improve immunity and produce clinical benefit in patients.

Objective To observe the changes in serum vancomycin trough concentration,and explore its optimal dosage in critical patients.Methods A retrospective study was conducted.Data of 66 patients who used vancomycin during July 2010 to May 2012 in surgical intensive care unit (SICU) of the First Affiliated Hospital of Sun Yat-Sen University were collected and analyzed.According to the endogenous creatinine clearance rate (CCr),the patients were divided into two groups:CCr normal group (≥ 70 mL/min) and CCr lowered group (＜70 mL/min).The distribution of vancomycin serum trough concentration between two groups,relationship between vancomycin serum trough concentrations and CCr,and the influence of vancomycin serum trough concentrations on the prognosis was analyzed.The difference between actual dosage and the recommended dosage in guideline was compared between two groups.Results 119 times of vancomycin serum trough concentration in 66 patients were enrolled,and it was found that only 20.17％ (24/119) reached the target concentration (15-20 mg/L),45.38％ (54/119)＜ 15 mg/L and 34.45％ (41/1 19) ＞20 mg/L.Vancomycin serum trough concentration in CCr normal group (55 cases) was (13.11 ± 6.84) mg/L,among them 65.5％ (36/55) attained lower trough concentrations (＜ 15 mg/L).In the subgroup with 15-20 mg/L trough serum concentrations,vancomycin doses were significantly lower than that of recommendation (g/d:1.95 ± 0.61 vs.2.73 ± 0.32,F=1.739,P=0.001).Vancomycin serum trough concentration in CCr lowered group (64 cases) was (20.49 ± 8.12) mg/L,with 51.5％ (33/64) of them showed higher trough concentrations (＞20 rag/L).In the subgroup with 15-20 mg/L vancomycin trough serum concentration,vancomycin doses were higher than that of recommendation (g/d:1.08 ±0.49 vs.0.78 ±0.19,F=11.294,P=0.062).There was no significant difference in 28-day mortality between patients with targeting trough serum concentrations and those without [22.2％ (4/18) vs.18.8％ (9/48),x2=0.009,P=0.924].Serum creatinine [odds ratio (OR)=1.001,95％ confidence interval (95％CI):0.990-1.012,P=0.000],vancomycin doses (OR=0.600,95％CI:0.251-1.434,P=0.003),age (OR=0.985,95％CI:0.955-1.015,P=0.015) and body mass index (OR=1.013,95％CI:0.967-1.062,P=0.022) were found to be correlated to serum trough concentrations by multiple linear regression analysis.Conclusions The rate of vancomycin serum trough concentrations reaching the standard is low in critical patients,so constant monitoring is necessary.Creatinine,vancomycin dosage,age and body mass index show a relatively significant influence on the serum trough concentrations,and they should be taken into consideration in dosage to be given.

Objective To evaluate the possibility of deep vein thrombosis defluvium of lower limb using ultrasonography to provide important reference for the implantation and retrieve of retrievable inferior vena cave (IVC ) filters.Methods Sixty-four patients who were diagnosed as lower limb deep vein thrombosis using ultrasonography were enrolled.Fourteen patients with critical values were allocated to high risk group,50 patients without critical value to low risk group.All the patients underwent inferior vena cava filter operation.Of all these patients,ultrosonography were performed once again before IVC filters were retrieved.Seventeen patients with broken thrombosis were allocated to unstable group,47 patients with stable thrombosis to stable group.Relationships between conditions of thrombosis and ultrasonography results were analysed.The conditions of thrombosis were recorded.The rates of thrombosis defluvium were compared.Results In high risk group,10 patients (71 .43%)had thrombosis.In low risk group,8 patients (16%)had thrombosis.There were significant differences in the rates of thrombosis defluvium beteen the high risk group and low risk group(P <0.05).In unstable group,12 patients (70.59%)had thrombosis.In stable group,6 patients (12.77%) had thrombosis,there were significant differences in the rates of thrombosis defluvium between the unstable group and stable group (P < 0.05 ).Conclusions Ultrasonography can be used to evaluate the possibility of lower extremity deep vein thrombosis defluvium which will guide the pratice of the retrievable inferior vena cava filter.

Objective To investigate the dynamic changes of serum interleukin(IL)-18,IL-1β and copeptin in acute cerebral infarction(ACI),and analyze the relationship with the serious degree of ACI.Methods The levels of serum IL-18,IL-1β and copeptin were measured by Double-antibody sanduicb enzyme-linked immunosorbent assay(ELISA)in 83 patients with ACI who were admitted to the hospital within 24 h,and neurological impairment were evaluated by European stroke scale(ESS)at the 1st,3rd and 7th day respectively after hospitalization.At the same time,the patients with ACI were compared with 32 normal adults.Results The levels of serum IL-18,IL-1β and copeptin at the 1st,3rd and 7th day after hospitalization were(131.30±31.62),(168.30±28.12),(141.26±24.23)ng/L,(0.35±0.04),(0.82±0.10),(0.52±0.21)μ g/L,and(3.64±0.26),(4.18±0.53),(3.26±2.41)μ g/L respectively.There were significant differences among different times respectively(P＜0.05),furthermore they were higher than those in normal adults[(119.12±27.42)ng/L,(0.21±0.08)μ g/L,(2.63±0.23)μ g/L](P＜0.05).Univariate Logistic regression analysis showed that age,copeptin,IL-18,IL-1β and ESS score was the influencing factor in the serious degree of ACI.There was no significant difference in assessing the serious degree of ACI by receiver operating characteristic(ROC)curve between IL-18 and age,copeptin,IL-1 β,ESS score(P＞0.05).Conclusions The serum levels of IL-18,IL-1β and copeptin are increasing after ACI,indicating that the inflammatory and immune factors may be involved in the development process of ACI.The serum levels of IL-18,IL-1β and copeptin can reflect the serious degree of ACI.