Objective To evaluate cerebrospinal fluid adenosine deaminase(CSF-ADA)activity in the diagnosis of tuberculous meningitis(TMB), and to observe its dynamic changes. Methods A total of 160 patients were included and were divided into two groups: 76 cases of TBM and 84 cases of non-TBM.Among the cases of non-TBM, there were 36 cases of bacterial meningitis, 30 cases of viral meningitis and 18 cases of cryptocoocal meningitis. All the patients were measured with their CSF-ADA activity by Enzymecoupled assay(Trinder method)and 47 patients of TBM were measured again after 2 weeks' and 6 weeks'antitubercular therapy. Results were expressed as(-x)± s. Mann-Whitney U test and paired-samples t test were used. Results CSF-ADA activity in TBM group was(12.9 ±6.4)U/L, while that in the non-TBM group was(6.0 ± 4.1)U/L, the difference was of statistical significance(U = 7.860, P ＜ 0.05). With the cutoff value of 9 U/L, the sensitivity and specificity to differentiate TBM from non-TBM was 84.21% and 83. 33%, respectively. CSF-ADA activity decreased in TBM patients after antitubercular treatment.Conclusions CSF-ADA activity can be an effective laboratory marker for early differential diagnosis of TMB with the cut-off value of 9 U/L. Dynamic changes of CSF-ADA activity may be a indicator for the effect of antitubercular treatment.

To improve the quality of experimental teaching,investigating the independent design experiments are carrying out in preventive medicine by public health experimental teaching center in our school.We take preventive medicine professional as an example,and besides the classical basis experiments,some experiments are verification project at present,in which students are not strongly interested.On the basis of the integration of the classic experiments,according to the national standard of the experimental method,we are trying to carry out part of the independent design experiments to meet the needs of students learning.The effect of those independent design experiments shows that it is appropriate carrying out independent design experiments on the basis of the existing classical experimental project in preventive medicine experimental teaching,to a certain extent,which will stimulate students' learning interest and enhance their sense of achievement.This study is conducive to the cultivation of medical students' innovation,independent thinking,analysis and problem-solving ability,practical ability and teamwork spirit.

AIM:To analyze curative effect of laser treatment for diabetic retinopathy (DR).METHODS:A total of 100 patients (136 eyes) with DR who were admitted to our hospital during January 2015 to December 2016 were enrolled in the study.All patients were given 532nm laser treatment.Changes of visual acuity and the incidence of complications were statistically analyzed after treatment, and the macula central fovea retinal thickness and hemodynamic changes of affected eyes were compared before and after treatment.The effects of laser treatment were compared among patients with different types of diabetes, patients in different DR stages and patients with different glycosylated hemoglobin (HbAlc) levels.RESULTS:After treatment, the macula central fovea retinal thickness, end diastolic velocity (EDV), pulsatility index (PI) and central retinal artery (CRA), mean flow velocity (Vm) significantly decreased (P<0.05).After treatment, there were 2 cases (2 eyes) of bleeding and 2 cases (2 eyes) of tractional retinal detachment.The effective improvement rate of visual acuity was 83.1%.There were significant differences in the improvement rate of visual acuity among patients with different types of diabetes [type 1 (60.0%) vs type 2 (84.9%)], patients in different DR stages [preproliferative diabetic retinopathy (NPDR) 92.3%, early proliferative stage (PDR) 85.1%, high-risk PDR 54.2%] and patients with different HbAlc levels (< 8% 91.8% vs ≥8% 73.0%) (P<0.05).CONCLUSION:The 532nm laser treatment is effective for DR.It can significantly improve the retinal hemodynamics and visual acuity and relieve macular edema.Types of diabetes mellitus, stages of DR and blood glucose control effect may affect the effects of laser treatment.

Objective To approach the method for improving the intellectual development,of whom had suffered from parity′s brain damage.Methods The patients were divided into 2 groups randomly(age range from 7 days to 18 months) who were observed and compared for 3 years.Group A was bundle of intervention which had been under early intervention program since infant.Group B was bundle of comparing of which had not been under early intervention.Results Observed for 6 months and 12 months,the intellectual development of group A was prior to that of group B(age 6 months P

Objective To analyze the ABCD1 gene mutations in 5 cases of X-linked adrenoleukodystrophy(X-ALD) patients and 2 cases of their mothers.Methods Of 5 patients with X-ALD,10 exons and flanking intronic sequences of ABCD1 gene were amplified by polyme-rase chain reaction,and then sequenced directly.The outcomes were compared with normal ABCD1 sequencings to identify the mutation type and site.Thirty normal men were examined in the mean time as control for the confirmation of mutations and gene polymorphisms.Results Three patients showed ABCD1 gene mutations,1 had a point mutation in exon 6,Arg518Gly(CGG→GGG);2 patients showed the same novel mutation in exon 1 with 8 bases deletion(134del8).Four gene polymorphisms were identified in exon 7.They were Gly551X(GGC→GGT),Arg554His(CGT→CAT),Gln567Arg(CAA→CGA) and Val582Ile(GTC→ATC).ABCD1 gene mutation was not found in 2 mothers from 2 unrelated fa-milies with X-ALD.Conclusions Three cases of 5 were detected for ABCD1 gene mutations.Between them,the 134del8 mutation is a novel one.Four new gene polymorphisms were detected in exon 7 in normal Chinese people,which were Gly551X,Arg554His,Gln567Arg and Val582Ile.

OBJECTIVE To investigate the application of antibacterials in patients accepted operation in grass-roots(hospitals),so to standardize the application of antibacterials and cut down the medical cost.METHODS Full-time administrators for nosocomial infection investigated the application of antibacterials in patients who accepted(operation) in Sep 2004,and filled in the questionnaires.RESULTS In 1 383 cases of 11 hospitals the application rate of antibacterials was 98.63%;in which 86.50% were for prophylactic usage and 13.50% for therapeutic usage;(29.90%) for single antibiotics treatment and 50.15% for bigeminy,18.70% were for trigeminy.Time of(application) differentiated(6.90,7.00,6.60d) fromⅠto Ⅲ kinds of operation.Per capita cost of antibacterials was $956.50(47.60%).CONCLUSIONS High cost of antibacterials results from such factors as multiple kinds,long time and(combined) application.

OBJECTIVETo explore the role and mechanism of oxidative inflammatory cascade in pancreatic fibrosis progression of chronic pancreatitis (CP) in mice induced by dibutyltin dichloride (DBTC) plus ethanol.

METHODSThirty-six KM mice were randomly divided into 2 groups (n = 18): control group and model group (DBTC combined with ethanol). The mice in model group were intravenously injected with DBTC (8 mg/kg) in tail vein and drink 10% ethanol. After modeling 2 weeks, 4 weeks and 8 weeks, the mice were anesthetized and sacrificed, the pathological changes and the degree of fibrosis in the pancreas were observed by HE and Masson staining, the F4/80 expression level were detected by immunohistochemistry, the content of superoxide dismutase (SOD), malondialdehyde(MDA) and myeloperoxidase (MPO) were measured in the pancreatic homogenates.

RESULTSThe fibroblasts and macrophages (f4/80 positive staining) could be seen obviously in pancreas of model group at 2 weeks. At 4 weeks and 8 weeks, macrophages infiltration increased and pancreatic tissue was substituted by the proliferation of fibrosis significantly. At every time-point, in pancreatic homogenates SOD was decreased, MDA and MPO markedly increased. There was significant differences between two groups (P < 0.05).

CONCLUSIONDBTC injection joint ethanol drinking can successfully establish the model of chronic pancreatitis and pancreatic fibrosis in mice. Oxidative inflammatory cascade plays an important role in the progression of pancreatic fibrosis.

Animals ; Disease Progression ; Ethanol ; adverse effects ; Fibrosis ; Immunohistochemistry ; Malondialdehyde ; metabolism ; Mice ; Organotin Compounds ; adverse effects ; Oxidative Stress ; Pancreas ; pathology ; Pancreatitis, Chronic ; chemically induced ; physiopathology ; Peroxidase ; metabolism ; Superoxide Dismutase ; metabolism

Objective To develop a clinical laboratory vehicle with advantages in mobility,deployment,automation and informatization to meet the requirements of disaster relief.Methods Ford transit V348 ambulance was used as the base,which was equipped with routine blood analyzer,routine urine analyzer,biochemical analyzer and etc.The same instruments,agents and procedures were adopted as those in the clinical laboratory department of rear hospital,and LIS,air cleaning system and necessary auxiliary units were also involved in the modification.Results The clinical laboratory vehicle increased the working efficiency while decreased the errors.Conclusion The vehicle fulfills mobile medical support for military operations other than war such as disaster relief,and thus is worthy promoting practically.

Objective To analyze the clinical and histopathologic characteristics in children with subcutaneous panniculitis-like T-cell lymphoma(SPTCL),and explore the pathological diagnosis and differential diagnosis,in order to boost paediatricians to better understanding the disease.Methods One case was diagnosed SPTCL with over 2 years protracted course of fever and multiple skin lesions.The evolvement of clinical presentation,the misdiagnosed experience,the histopathological features,the immunohistochemical results and T cell receptor(TCR)gene cloning rearrangement were observed.The related literatures published were reviewed.Results Skin biopsy showed that the histopathologic findings were limited within subcutaneous fatty tissue,the atypical lymphocytes characteristically rimmed individual fat cells in a lace-like pattern.Immunophenotypic studies showed CD45,CD45RO,CD3,CD5,T cell intracellular antigen-1(TIA-1)and perforin usually expressed possitive,while CD10,CD20,CD56,CD68,epithelial membrane antigen(EMA)and cytokeratin(CK)were negative,implying tumor cells derived from T-cell.The results of TCR gene rearrangement as following:IgH FR2(+),FR3A(-);TCR ? JVI(-),JVII(+);TCR? JD1(-),JD2(-).Although the protocol of children's T-cell Non-Hodgkin lymphoma was administrated,the treatment outcome was poor.Conclusion SPTCL is a special primary cutaneous lymphoma with poor prognosis,skin biopsy of suffered lesion is an important method for the diagnosis of SPTCL children with unclear recurrent fever and multiple skin lesions.

Objective To evaluate the clinical significance of CT angiography(CTA)in the diagnosis of arterioportal shunts(APS)associated with hepatocellular carcinoma(HCC).Methods One hundred and twenty-seven consecutive HCC patients accepted both dynamic enhancement CT and DSA examinations.The interval between CT and DSA exam was from 3 to 15 days.Based on transverse CT images in hepatic artery phase,CTA was performed for all the patients.By contrast with DSA results,the capabilities of transverse CT and transverse images combined with CTA in APS diagnosis were analyzed. Results In all 127 HCC cases,52 cases with APS were confirmed by DSA(40.94%),33 with central type of APS and 19 with peripheral type.Diagnostic sensitivity of APS based on transverse CT and combined CTA with transverse CT images were both 94.23%(49/52).However,specificity was 84.00%(63/75) and 97.33%(73/75),respectively,accuracy was 88.19%(112/127)and 96.06%(122/127),the predictive value of positive cases was 80.33%(49/61)and 96.08%(49/51),and the predictive value of negative cases was 95.45%(63/66)and 96.05%(73/76).Combined with CTA,false positive cases of 4 central type of APS and 6 peripheral type of APS were excluded which were demonstrated by transverse CT images.By contrast with DSA,the coincidence rate of the type of APS diagnosed by transverse images combined with CTA was 88.46%(46/52),including 90.91%(30/33)of central type of APS and 84.21%(16/19)of peripheral type.The supplying arteries of central type of APS were intuitively displayed by CTA in 23 cases,19 from proper hepatic artery and 4 from gastro-duodenal artery.Conclusion CTA techniques based on the dynamic enhancement CT exams could effectively promote the specificity and the accuracy of APS diagnosis.