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 study the methods of clinic diagnosis and treatment for chronic lumbar pain induced by lumbo-sacral compartment syndrome. Methods Thirty-three patients with chronic lumbar pain induced by lumbo-sacral compartment syndrome were diagnosed by physical, radiological examination and intra lumbo-sacral muscle compartmental pressure measurement. 33 patients consisted of 15 men and 18 women, with the mean age 42.3 years, and mean duration of chronic lumbar pain was 27 years. Lumbar erector spinae osteo-facial compartment was decompressed using mini-invasive surgery. Lumbar and abdomen muscles were rehabilitated extensively after operation. Results After operation, symptoms of low back pain were alleviated significantly, and walking distance were promoted as well. Post operative flexion and extension of lumbar spine were increased to (15??0.5?) and (7??0.7?) respectively. Intramuscular pressure in rest state, during movement and no more than 6 min after movement was (6.8?0.8), (162.3?12.35) and (7.1?0.6) mm Hg respectively [before operation was(10.4?0.9), (187.1?11.16) and (13.2?1.3) mm Hg respectively, P

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.

This paper reports the nursing care of 7 patients with liver cirrhosis during pregnancy and childbirth. During the pregnancy period,nursing care focused on integrated management,monitoring of the dynamic changes of liver cirrhosis and individualized care. During delivery and perioperative period,supportive treatment was implemented and complications such as upper gastrointestinal hemorrhage,postpartum hemorrhage and infections were prevented. The 7 patients got through the perinatal period safely.

ObjectiveTo investigate anatomical characteristics of the medial foot vessels and effects of different vascular pedicle skin flaps in repair of foot and ankle trauma.MethodsThirty adult cadaveric lower limbs were injected with red latex through the popliteal artery and posterior tibial artery to anatomically observe the cutaneous arterial origin,branches,distribution and anastomosis of the medial foot.Then,anterior medial malleolar artery perforator flaps and distally-based medial foot flaps were harvested and used for repairing foot and ankle trauma of 16 patients.Results The origin of cutaneous blood vessels of the medial foot was diversified and mainly included the anterior medial malleolar artery,medial tarsal artery,and arterial arcades anastomosing with anterior posterior branches of the two former arteries and the superficial branches of plantar digital artery and the medial plantar artery.According to distribution area of the anterior medial malleolar artery and the medial tarsal artery,the vascular anatomy of the medial foot skin was classified into three types.Clinically,all the flaps survived.Follow-up ranged from 2 weeks to 20 months,which showed normal color,good shape and good pain and warm sensation of the flaps.ConclusionThe anterior medial malleolar artery perforator flaps present good reconstruction of soft tissue defects around the ankle,whereas the distally-based medial foot flaps present good reconstruction of soft tissue defects of the mid-forefoot.

Objective To investigate the pathogenesis and clinical features of ankylosing spondylitis (AS) concurrent with multiple myeloma (MM).Methods The clinical characteristics,pathogenesis,diagnosis and treatment of 3 cases who were diagnosed as AS concurrent with MM were analyzed and relevant literatures were reviewed.Results MM was confirmed in patients who had long-term stable AS.A wide variety of manifestations,including persistent pain in spine and thorax,pathologic fracture,anemia,kidney damage and nervous system abnormalities were frequently presented.These patients were insensitive to nonsteroidal anti-inflammatory drug treatment,and they had a unfavorable prognosis.Conclusion Patients who are diagnosed as AS concurrent with MM can present with a variety of clinical features.Manifestations which are difficult to explain clinically by AS and poor response to treatment especially when the patients have longterm stable AS are potential clues for MM.

Objective To explore the teaching effect ofOrgan-system-based curriculum in-tegrated model on clinical graduation field work. Method 150 clinical medical undergraduates of Grade 2009 from Shenyang Medical College selected, were randomly divided into the experimental group (75 persons) and the control group (75 persons). The experimental group adopted the means of the Organ-system-based curriculum integrated model, namely practicing according to human organ-system and the control group accepted the traditional pattern of discipline centered practice during the clinical graduation internship. The two groups of students carried out questionnaire survey and comprehend examinations when the practice ended, and then statistics analysis (the chi square test, t test) was done by the SPSS 19.0 software between the two groups in order to explore the teaching effect. Result The students' satisfaction degree from six aspects of the questionnaire survey showed in the experimental group was significantly higher than that in the control group (the degree of recognition of practicing pattern: χ2=11.437, P=0.003; the architectonic integrality: χ2=9.881, P=0.007; the im-provement of the autonomic learning ability χ2=9.643, P=0.008; the teaching method and means: χ2=11.006, P=0.004; motivating learning interest: χ2=13.550, P=0.001; increasing the ability of clinical thinking: χ2=13.309, P=0.001), and the average test scores of students from three parts of examination results showed by comprehend examinations (speculative knowledge examination: t=2.768, P=0.006;technical skill examination: t=2.212, P=0.029; clinical capability examination: t=5.015, P=0.000) in the experimental group was obviously higher than that in the control group and the difference was sig-nificant. Conclusion Organ-system-based curriculum integrated model on clinical graduation in-ternship is generally approved by the students, which has significantly improved the students' clinical thinking ability, and the quality of graduation internship teaching.

OBJECTIVE: Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder that causes vertigo. Study of BPPV has dramatically rapid progress in recent years. We analyze the BPPV growth METHOD: We searched the international data quantity year by year in database of PubMed, ScienceDirect and WILEY before 2014 respectively, then we searched the domestic data quantity year by year in database of CNKI, VIP and Wanfang Data before 2015 by selecting "Benign paroxysmal positional vertigo" as the keywords. Then we carried out regression analysis with the gathered results in above databases to determine data growth regularity and main factors that affect future development of BPPV. Also, we analyzes published BPPV papers in domestic and international journals. RESULT: PubMed database contains 808 literatures, ScienceDirect contains 177 database and WILEY contains 46 literatures, All together we collected 1 038 international articles. CNKI contains 440 literatures, VIP contains 580 literatures and WanFang data contains 449 literatures. All together we collected 1 469 domestic literatures. It shows the rising trend of the literature accumulation amount of BPPV. The scattered point diagram of BPPV shows an exponential growing trend, which was growing slowly in the early time but rapidly in recent years. CONCLUSION It shows that the development of BPPV has three stages from international arical: exploration period (before 1985), breakthrough period (1986-1998). The deepening stage (after 1998), Chinese literature also has three stages from domestic BPPV precess. Blank period (before the year of 1982), the enlightenment period (1982-2004), the deepening stage (after the year of 2004). In the pregress of BPPV, many outsantding sccholars played an important role in domestic scitifction of researching, which has produced a certain influence in the worldwide.
Benign Paroxysmal Positional Vertigo ; Bibliometrics ; Databases, Factual ; Humans

BACKGROUND: The principal deterrent to the success for hematopoietic stem cell transplantation (HSCT) is the complications after transplantation. The complications are associates with the conditioning regimens in the early stage. The highly-effective preparative regimens of proper dose and low-toxicity are the key to the successful HSCT.OBJECTIVE: To evaluate the curative effects and regimen related toxicity (RRT) of high-dose alkylating-agent-based chemotherapy as conditioning regimens for HSCT in the patients with hematological malignancies.DESIGN: Controlled study with observation.SETTING: Department of Hematology, Affiliated Hospital of Xuzhou Medical College.PARTICIPANTS: A total of 45 patients with leukemia and lymphoma hospitalized at Affiliated Hospital of Xuzhou Medical College from July 1997 to February 2006 were enrolled, including 31 males and 14 females. The median age was 31 years (from 7 to 52 years). The median course was 8 months (from 5 to 17 months) until transplantation.METHODS: Totally 45 patients with leukemia and lymphoma approached or got complete remission were treated by bone marrow transplantation and peripheral blood stem cell transplantation with preparative regimens of high-dose alkylating-agent-based chemotherapy. RRT was graded according to Bearman proposal, from grade 0 (no toxicity) to grade Ⅳ (fatal toxicity). The period of hematopoietic reconstitution, the rates of complete remission and relapse and disease-free survival were statistically observed in transplant recipients.MAIN OUTCOME MEASURES: Occurrence of RRT as conditioning regimens.RESULTS: ①Five patients did not show any toxicity. The greatest toxicity of grade Ⅲ was uncommon (13%, 6/45). Most of the cases with RRT were in grade Ⅰ - Ⅱ and severe oases in grade Ⅲ were rare. In grade Ⅰ - Ⅱ, stomatocace and gastrointestinal toxicity were common respectively of 73% (33/45) and 51% (23/45) which were recovered in short time after treatment; Heart toxicity was rare and only in grade Ⅰ, most of which were tachyoardia and changes of ST-T shape. The increase of transaminase was common in the clinical manifestations of liver RRT except two cases of HVOD.There were four oases of HC, in which one was delayed. RRT on kidney, lungs and CNS was uncommon. ②Totally 43 patients engrafted gained hematopoietic reconstitution, 2 patients died of implant failure (4%). Within the median follow-up period of 37 (8-102) months, 10 patients relapsed, 5 patients died of transplantation-related complications and 28 patients were alive in a disease-free situation (62.2%). The cause of death within 100 days after transplantation was ordinal as acute graft-versus-host disease (GVHD), cytomegalovirus (CMV) interstitial pneumonia, disseminated infections,multiple organ failure and early relapses.CONCLUSION: Alkylating-agent-based conditioning regimens may be well tolerated with low toxicities for HSCT in leukemia and lymphoma.

OBJECTIVETo study tetrahydropalmatine's permeative properties of acupoint and non-adupoint transdermal administration of baijiezi tufang in vitro and in vivo.

METHODTaking tetrahydropalmatine as an evaluative component to assess the permeative of baijiezi tufang in acupoint skin and non-acupoint skin with the modified Franz diffusion cell method and in vivo penetration studies. The content of tetrahydropalmatine was determined by a HPLC method.

RESULTThe 24 hours cumulative permeation amount through acupoint skin was (13.53 +/- 3.92) microg x cm(-2), about 4 times higher than non-acupoint skin. The steady-state infiltration rates of tetrahydropalmatine in acupoint skin was (0.659 1 microg x cm(-2) x h(-1)), 4.5 times higher than non-acupoint skin. The content in acupoint skin was signally higher than that in non-acupoint skin (P < 0.05). An accumulation of fluorescence can be clearly seen in the four layers: stratum corneum > viable epidermis > dermis > subcutaneous.

CONCLUSIONIn vitro and in vivo studies show that the permeation of baijiezi tufang in acupoint skin was better than in non-acupoint skin, following a higher cumulative amount and skin content.

Acupuncture Points ; Administration, Cutaneous ; Animals ; Berberine Alkaloids ; administration & dosage ; pharmacokinetics ; Chromatography, High Pressure Liquid ; Drugs, Chinese Herbal ; administration & dosage ; metabolism ; Guinea Pigs ; Skin ; metabolism