Objective　To study the diagnostic value of pleural fluid telomerase activity in distinguishing a malignant from a benign pleural effusion. Methods　Using a PCR-based assay, telomerase activity was examined in the pleural fluid cells obstained from 69 patients with pleural effusions (37 malignant, 32 benign). Results were compared with cytologic evaluation and carcinoembryonic antigen (CEA). Results　Of the 37 malignant specimens，26（70.27%）contained detectable telomerase activity. The positive rate in malignant pleural effusions was significantly higher than that in benign origin (2/32). Detection of telomerase in effusions was more sensitive than CEA level evaluation for the identification of pleural malignancy (telomerase assay: sensitivity=70.27%, specificity=93.75%; CEA: sensitivity=51.35%, specificity=96.87%). The consistant rate of telomerase with cytology was 54.05%. Conclusion　The detection of telomerase activity may be a useful adjunct to cytopathologic methods in the diagnosis of malignant pleural effusions. It may be useful in differential diagnosis of benign and malignant pleural effusions.

Objective To observe the efficacy and safety of pleural perfusion of recombinant human endostain ( endostar) combined with cisplatin ( DDP) in lung cancer patients with pleural effusion.Methods 80 patients with pleural effusion of lung cancer from January 2011 to December 2014 in our hospital were selected and randomly divided into the treatment group and the control group two groups with 40 cases in each group.Recombinant human endostain and DDP were injected into pleural cavity in the treatment group, the same dose of DDP was injected into the control group.Pleural effusion, KPS, Toxic and the exepress of vascular endothelial growth factor ( VEGF) of pleural effusion were measured before and after treatment. Results After treatment, the clinical efficacy of the observation group (RR), quality of life improvement rate and the level of VEGF in pleural effusion was significantly higher than that in the control group, the difference was statistically significant (P <0.05).The level of VEGF in Bloody pleural effusion was higher than in the non-bloody pleural effusion in the treatment group, there was significant difference (P<0.05).The observation group was higher than that of non hemorrhagic pleural effusion VEGF , the difference was statistically significant ( P <0.05 ) , both of them could lead to the decrease of VEGF level after treatmen, but there was no statistical significance between the two groups.Conclusion Clinical efficacy of intrapleural injection of recombinant human endostatin combined with cisplatin in patients with lung cancer complicated with pleural effusion, low adverse reaction, it is speculated that the recombinant human endostatin can inhibit the growth of tumor and the formation of pleural effusion by inhibiting the expression of VEGF in combination with cisplatin, it could effectively improve the quality of life of patients and prolong life.

Treated by CCM for half year in 92 cases of pre -cancerous lesions of stomach, the pathological mean score for special hyperplasia were lowered significantly and different from that before treatement. The pathological scoring was also markedly lowered as compared with HP scoring.

Objective To probe into the role of nursing classification and marking management in ICU nursing management. Methods According to the admission date,the first 87 patients hospitalized in our department were assigned into the control group and another 84 into the intervention group.Then the human resources were divided based on the ABCD nursing classification and marking management for ICU.The two groups were compared in terms of adverse events.Results The incidences of pressure sores, non-planned extubation,improper clinostatism for using respirator,hypoglucycaemia during reinforced treatment with insulin, respirator-associated pulmonary pneumonia,tube-associated infection,and multidrug resistant bacteria in the intervention group were all significantly lower than those in the control group (allP<0.05).Conclusion The nursing classification and marking management for ICU nursing management can enhance the nursing quality.

Objective To investigate the effective methods for detecting the susceptibility of Staphylococcus aureus to Vancomycin. Methods An isolate of h-VRSA (heterogeneous Vancomycin-resistant Staphylococcus aureus) isolated from clinical specimen was inoculated on the increasing concentration of vancomycin agars. Varied degree of vancomycin of resistant S. aureus were obtained. The susceptibilities of these S. aureus to vancomycin were tested by agar screening test, broth microdilution method, E-test, disk diffusion method and automated methods. Results Agar screening test, broth microdilution method and E-test are effective for detection of vancomycin-intermediate S. aureus VISA, but disk diffusion and automated methods could not detect VISA. Conclusion Broth microdilution method and E-test are acceptable methods for susceptibility testing of S. aureus to vancomycin. The laboratories using automated methods and disk diffusion method as routine susceptibility test should consider adding a vancomycin agar screen plate to enhance detection of VRSA and VISA.

Objective To study the shift handover experience of ICU clinical nurses. Method About 19 ICU nurses were enrolled in the investigation using semi-structured interviews and the results were analyzed with phenomenological analysis. Result Their shift handover experience were summarized into 6 themes, that is high recognition on the importance of shift handover, lack of standardized processes, incomplete contents of shift handover, frequent interruption, forgotten information and repeated information. Conclusions Shift handover is an important part of ICU nursing function but there are many problems in the practical operation. The nurse managers need to standard the handover process, stipulate handover contents and enhance the training on shift handover with specialist examination and positive results for the purpose of improving the quality of the shift handover.

Objective:To analyze deceleration capacity of heart rate (DC) in patients with ventricular arrhythmia , and explore its predictive value for ventricular arrhythmia .Methods :Dynamic electrocardiogram (DCG) data of outpatients and inpatients ,who were treated in our hospital from Jan 2012 to Jul 2015 ,were retrospectively ana‐lyzed .A total of 41 rehabilitation patients with ventricular tachycardia (VT) directly detected by DCG were treated as VT group ,another 37 cases with similar general data and non‐tachycardia were enrolled as non‐tachycardia group in the same period .DCG was used to measure and calculate DC in all subjects , DC indexes were compared between two groups .Results:DC<4.5 ms was regarded as abnormal and DC<2.5 ms was regarded as significantly abnor‐mal .Compared with non-tachycardia group ,DC significantly reduced [ (8.72 ± 1.78) ms vs .(4.01 ± 1.90) ms] , P<0.01 ;there were significant rise in abnormal DC rate (5.41% vs .51.22% ) and significant abnormal DC rate (0 vs .29.27% ) in VT group , P<0.01 both .Conclusion:Detection rate of abnormal DC is high in VT patients .DC measurement is helpful for predicting ventricular arrhythmia and sudden cardiac death .

Objective To summarize the nursing key points of one patient of external ankle foot of gout patients with purulent infection which caused by gout stone burst in order to provide reference for the similar case. Methods Using silver dressing for local treatment of gout during wound, on the basis of control the basic diseases, local wound treatment focus was mainly reflected in: infection control, fluid management and wound debridement. Results After 86 days of treatment. The wound had already healed. Conclusions Rational use of silver dressing gout can promote wound healing and relieve the pain of patients.

0.05).In1?g/kg dosage group,no neutralizing activity was detected at the end of convalescent period.CONCLUSION:The neutralizing antibodies can be detected in the serum of both hamsters and rhesus monkeys after repeating injection of recombinant consensus interferon?.The titers of antibody are in direct ratio with the duration and the injected dose.

BACKGROUND: Neuroleptic agents are effective in treating Tourette syndrome (TS). Side effects such as acute myodystonia and oculogyric crisis as well as the risk of delayed dyskinesia have led to search for alternative therapy.OBJECTIVE: To explore the effects of metoclopramide in controlling the symptoms of TS and improving the intelligence and memory function without causing extrapyramidal side effects.DESIGN: Randomized controlled trial and blind method.SETTING: Neurological Department of Xiangya Hospital Affiliated to Central South University; Institute of Traditional Chinese Medicine of Hunan Province; Neurological Department of the First People's Hospital of Nanning City; Public Health College of Central South University.PARTICIPANTS: Fifty patients with TS came from Tic Specialty Clinic,Neurological Department of Xiangya Hospital, between January 2000 and June 2001. Patients and their family members agreed toaccept our medical treatment and reexamination on fixed dates. There were 38 males and 12 females aged 5-21 years with the mean age of (10.4±4.2) years. All of them were divided into metoclopramide group and haloperidol group with 25 in each group.METHODS: Metoclopramide and haloperidol were white tablets bottled without tag (100 tablets of white color medicine in each bottle). The two types of medicine in each bottle were marked Ⅰ or Ⅱ, respectively. The blind method (patients, their parents and evaluation blinded) was used to test the real biochemical nature of the medicine. Medicine was given by a specific doctor on regular days (2, 4, 8, 16 weeks) to patients on their revisit. The daily dose of metoclopramide for body weight was 0.5-2 mg/(kg· d) and haloperidol was 0.05 mg/(kg· d) and was assigned 3-4 times (principle of dose individuality). In addition, TS patients with severe tics in metoclopramide group would receive metoclopramide 10 mg by intramuscular injection twice a day, at the initial treatment for 2-4 days. ①Before and after treatment, TS severity of patients at weeks 2, 4, 8 and 16 was evaluated by YGTSS (the total score was 100 points; the higher the score, the more severe the condition and overall impairment). ② The clinical curative effect of the medicines was evaluated with YGTSS deduction rate before and after treatment. ③ Asberg side-effect rating score: The lower the score, the fewer and milder the side effects. ④ The cognition function was evaluated with WISC score before treatment and after 3 months of treatment. WISC consisted of language and performance components with 11 subtests, while memory scale category had 10 subtests (memory score lower than the standard indicated problem in memory function).MAIN OUTCOME MEASURES: ① Comparison of YGTSS in patients before and after treatment; ② comparison of efficacy in patients of the two groups; ③ comparison of intelligence quotient and memory quotient of patients before and after treatment; ④ adverse events and side effects.RESULTS: Totally 50 patients entered the final analysis. ① Comparison of Tourette' s syndrome in patients before and after treatment: YGTSS score in the two groups decreased significantly after treatment. The comparison of the differences suggested that metoclopramide had better curative effect than haloperidol. In metoclopramide group, YGTSS score was reduced steadily at weeks 2, 4, 8 and 16. In haloperidol group, YGTSS score was also reduced steadily at weeks 2, 8 and 16, but it was similar at week 2 and week 4. ② Comparison of efficacy in patients of the two groups: The total clinical curative effect rate was 92% (23/25) in both groups withoutany difference (P ＞ 0.05). ③ Comparison of intelligence quotient beforeand after treatment: In both metoclopramide group and haloperidol group itwas higher after treatment than before treatment (93.0±15.1, 87.0±14.6; 93.2±17.0, 87.3±13.6, t=3.43, 2.3, P ＜ 0.01). ④ Comparison of memory quo tient of patients before and after treatment: It was higher only in metoclo pramide group after treatment than before treatment (87.8±12.8, 75.8±15.5, t=3.30, P ＜ 0.01). ⑤ Score of Asberg side effects: It was lower in metoclo pramide group than in haloperidol group [(1.00±0.76), (3.24±1.40) points, t=7.05, P ＜ 0.01]. CONCLUSION: The results suggest that metoclopramide is effective in con trolling the symptoms of TS and improving intelligence and memory function. Metoclopramide causes mild side effects, but no extrapyramidal side effects.