Objective To discuss the clinical value of plasma (1,3)-β-D -glucan detection (G test) for early diagnosis of invasive fungal infections (IFI).Methods A total of 180 cases of IFI were divided into suspec-ted group (84 cases),diagnosed group (49 cases)and clinical diagnosis group (47 cases).At the same period,the other 44 hospitalization patients with bacterial infection and 53 healthy persons were selected.All personnel were par-ticipated in the experiment using the MB -80 system for rapid detection of microbial dynamic detection,simultaneous plasma G test was evaluated using ROC curve analysis G optimal threshold test.Results Candida albicans was a common respiratory infections of IFI.Compared with bacterial group (9.4pg/mL)and normal group (7.8pg/mL) plasma glucan content median,IFI group plasma G test (29.3pg/mL)was significantly higher,and the differences were statistically significant(Z =-2.41,P =0.015;Z =-2.19,P =0.028),Compared with the median plasma glu-can content of the diagnosis group (105.8pg/mL)and clinical diagnosis group (46.3pg/mL),to be diagnosed group (8.1pg/mL)was significantly lower,and the differences were statistically significant(Z =-2.99,P =0.003;Z =-2.19,P =0.027).ROC curve analysis showed that when the cutoff value was 9.35pg/mL,its specificity (67.2%), sensitivity (70.3%)and negative /positive predictive value (69.3% /65.8%)were the best,and more consistent with the culture method,the Kappa value was 0.603,the difference was statistically significant (P =0.036 ). Conclusion In the early diagnosis of IFI,plasma G test has good results and can be widely used.

Objective To discuss the detection value of(1,3)-β-D -glucan in the early diagnosis of fun-gal infection in clinic.Methods 86 patients with deep fungal infection were selected as the study group,and 24 cases of healthy volunteers were selected as the control group,all groups took plasma G test,while cultivating specimens sus-pected infection and deep fungal infections in patients were divided according to culture -negative group and positive group,plasma G test results were compared.Results In the control group,G test was (6.12 ±2.87)×10 -3 ng/mL in plasma,deep fungal infection negative,positive test results were (32.58 ±24.12)×10 -3 ng/mL and (101.28 ± 36.04)×10 -3 ng/mL in plasma G respectively,positive group G results in plasma were significantly increased,the differences were statistically significant(t =18.28,7.92,P =0.036,0.042);both positive plasma G test results were significantly higher than that of the negative group,the difference was statistically significant(t =12.16,P =0.038). Plasma G test positive diagnosis of deep fungal infection was 79.1%,significantly better than the fungal culture 50.0%,the difference was statistically significant(χ2 =31.26,P =0.002).Conclusion In early clinical diagnosis of deep true infection,plasma G test positive rate is higher than fungal culture,and is worthy of wider application.

Objective: Through managing objectives in our hospital, promote the hospital management. Methods:Use expert advice method to establish the target assessment index system, with the weighted index method to calculate the final score. Results: According to the characteristics of the department, develop differentiated, personalized indicators; objective management system consists of 3 level indicators medical examination standard (680 points), scientific research and teaching standards (220 points), departmental management assessment criteria(100 points), and 45 secondary indicator of internal medicine, surgical 49 second-level indicators. Conclusion: Objective management is the starting point of the hospital and meticulous management, and implementation of objective management enhance the awareness of the collective participation of the medical staffs at all levels, so that the department changes from passive management to active management, and it enhances department execution and promotes the hospital science directly.

0.05.Conclusion Using XT-2000i Automated Hematology Analyzer to test the reticulocyte the reproducibility is better,and the linearity can content well with clinic,the rate of carry contamination is low,the stability is better too.Compared XT-2000i with the manual methods,the relativity is better. It can replace the manual methods.

Objective To analyze clinical manifestation,diagnosis and treatment of 8 patients with gas gangrene in Wenchuan earthquake.Methods Eight patients with gas gangrene in Wenchuan earthquake were selected for analysis on their clinical manifestations.We finally diagnosed gas gangrene based on patients'clinical manifestation and the cultured ciostridium in the focus of infection.All the patients were treated with antibiotics,repeated surgical debridement,hyperbaric oxygen and nutritional support.Results Most patients had no erepitation of the extremities but found gas in interstice of tissues identified by X-ray,B-ultrasound and CT scanning.Film preparation of efflusion of all patients showed clostridium and bacterial culture manifested mainly perfringens.Most patients were demonstrated to be with polyinfection.In addition,all patients were characterized by pitchy necrotic tissues,effusion,systemic decrease of red blood cells,increase of white blood cells and platelet.No death or amputation occurred under active combined therapy.Conciusions Earthquake induces mainly open trauma often combined with mixed infection,when gas gangrene is one of main special infections.The predominant combined therapies include utility of antibiotics and thorough surgical debridement,while hyperbaric oxygen and nutritional support are important and effective adjunctive therapies.

Objective To explore the prognostic risk factors of low level malignant obstructive jaundice treated with transhapetic biliary drainage.Methods The clinical data of 142 patients with low level malignant obstructive jaundice received percutaneous transhapetic biliary drainage management from January 2010 to June 2013 were retrospectively analyzed.The study parameters included gender,age,tumor type,preoperative obstructive time,preoperative infection,drainage method,Child-Pugh grade,serum total bilirubin (TBIL),albumin (ALB),serum creatinine (SCr),the postoperative declining degree of bilirubin and postoperative antineoplastic therapy.The prognostic risk factors were evaluated.Results Single variable analysis showed that preoperative infection (P =0.006),Child-Pugh grade (P =0.004),SCr (P =0.043),the postoperative declining degree of TBIL (P =0.001) and postoperative antineoplastic therapy (P =0.015) were the related factors for survival time.The further Logistic regression analysis showed that preoperative infection (OR =3.729,95％ CI 1.332-6.363,P =0.040),Child-Pugh grade ≥ 10 scores (OR =0.513,95％ CI 0.375-1.276,P =0.018) and postoperative antineoplastic therapy (OR =0.668,95％ CI 0.210-2.026,P =0.038) were the related factors for survival time.Conclusion In treating of low level malignant obstructive jaundice with transhapetic biliary drainage,the preoperative infection,Child-Pugh grade and postoperative antineoplastic therapy may be the important related factors that affect the patient's survival time,to evaluate the prognosis of these patients has important reference meaning.

The paper covered dominant models and organization of healthcare alliances in Xinjiang, illustrating the hospital group model, synergy development model, focused partnership support model, three-level integration model, and other business models.As described by the authors, healthcare alliances in Xinjiang, thanks to telemedicine, have achieved initial success by means of disciplines support, primary care human resources, new technologies and new service spreading, and promotion of appropriate medical techniques, in such aspects as regional medical cooperation, population benefits and medical resources sharing.

Bao-Xie-Ning (BXN), a traditional Chinese herbal medicine (CHM) formula composed of Fructus Evodiae, Flos Caryophylli and Cortex Cinnamomi, and used for the treatment of infant diarrheal illness, was subject to systematic assessment for its putative multiple pharmacodynamic effects and pharmacological antidiarrheal mechanisms.

The prognosis of advanced gastric cancer (AGC) is extremely poor. There is no standard and satisfactory treatment strategy for AGC. In clinical practice, some AGC patients can achieve long-term survival. However, it is not clear which type of AGC can benefit the best in specific treatment mode. Because of the high heterogeneity of AGC, it is particularly important to further dig out more significant beneficiary groups. Therefore, experts put forward the classification based on the biological characteristics and the surgery-oriented classification to predict and select patients who benefit from conversion therapy. While for immunotherapy, the biomarkers, molecular subtyping and potential combination strategies are explored to break through its bottleneck in the treatment in AGC that only certain individuals benefit from it. The authors review the research progress in treatment for advanced gastric cancer.

Objective To investigate prevalence of metabolic syndrome (MS) in population at high-risk for diabetes in Changfeng community of Shanghai. Methods Totally, 982 persons aged 40-79 years without previous history of diabetes, but with risk factors for diabetes from Changfeng community in Shanghai were screened by questionnaire, physical examinations, lipid profile and oral glucose tolerance test. Prevalence of MS and its clinical characteristic were observed. Results Overall prevalence of MS was 44. 6% (438/982) in Changfeng community, significantly higher in women of 48.6% (341/701) than that in men of 34. 5% (97/281) (P<0.01). Prevalence of MS increased with age in women (P <0. 01 ), but not in men (P>0.05). Components of MS ranking from high to low were hypertension of 66. 5% (653/982), abdominal obesity of 62.8% (617/982), decreased high-density lipoprotein-cholesterol (HDL-C) of 49. 4% (485/982), increased triglyceride (TG) of 46. 0% (452/982) and increased fasting glucose of 35.7% (351/982). There were 55.9% (245/438) of MS patients with three or more MS components in addition to abdominal obesity. Conclusions Prevalence of MS is higher in community population at high-risk for diabetes and more than half of the MS patients have three or more risk factors for cardiovascular disease.