Objective:To study the clinical features of histiocytic necrotizing lymphadenitis. Method: Eleven pa-tients with histiocytic necrotizing lymphadenitis were collected to analyze the clinical features, pathological features of biopsy lymph nodes,diagnosis and treatment. Result:Lymph node swelling of neck and persistent fever were de-tected in all patients. The leukocyte reduction and swiftness of ESR in serum were detected in most patients. The final diagnosis of histiocytic necrotizing lymphadenitis was confirmed by biopsy investigation of the pathology. The pathological features included distinctive necrosis, loss of lymph node structure, infiltration with histiocytes and lymphocytes, absence of neutrophils. All patients were treated with glucocorticoid for 2 to 4 months. The patients improved significantly and were not recurrence during follow up visit. Conclusion: There was no specific clinical manifestation of histiocytic necrotizing lymphadenitis and which easy to misdiagnose. Diagnosis of histiocytic ne-crotizing lymphadenitis relies on the pathological examination of enlarged lymph nodes.

Pituitary adenoma with cerebrospinal fluid rhinorrhea is rare clinically. In this paper, through the analysis of a pituitary adenoma patient with initial symptom of cerebrospinal fluid rhinorrhea, we look forward to provide evidence for clinical diagnosis, so that we can avoid misdiagnosis.
Adenoma ; complications ; diagnosis ; Cerebrospinal Fluid Rhinorrhea ; etiology ; Humans ; Pituitary Neoplasms ; complications ; diagnosis

Phytantriol (PT), ethanol (ET) and water were used to prepare in situ cubic liquid crystal (ISV2). The pseudo-ternary phase diagram of PT-ET-water was constructed and isotropic solution formulations were chosen for further optimization. The physicochemical properties of isotropic solution formulations were evaluated to optimize the composition of ISV2. In situ hexagonal liquid crystals (ISH2) were prepared based on the composition of ISV2 with the addition of vitamin E acetate (VitEA) and the amount of VitEA was optimized by in vitro release behavior. The phase structures of liquid crystalline gels formed by ISV2 and ISH2 in excess water were confirmed by crossed polarized light microscopy and small angle X-ray scattering, respectively. Rheological properties of ISV2 and ISH2 were studied by a DHR-2 rheometer. In vitro drug release studies were conducted by using a dialysis membrane diffusion method. Pharmacokinetics was investigated by determination of sinomenine hydrochloride (SMH) concentration in synovial membrane after intra-articular injection of SMH-loaded ISH2 in adjuvant-induced arthritis rats. The optimal ISV2 (PT/ET/water, 64 : 16 : 20, w/w/w) loaded with 6 mg x g(-1) of SMH showed a suitable pH, injectable and formed a cubic liquid crystalline gel in situ with minimum water absorption in the shortest time. The optimal ISV2 was able to sustain the drug release for 144 h. The optimal ISH2 system was prepared by addition of 5% VitEA into PT in the optimal ISV2 system. This ISH2 (PT/VitEA/ET/water, 60.8 : 3.2 : 16 : 20, w/w/w/w) was an injectable isotropic solution with suitable pH. The new ISH2 was able to sustain the drug release for more than 240 h. Local pharmacokinetics study indicated that the retention time and AUC(0-∞) of ISH2 group were increased significantly compared with that of SMH solution group and the AUC(0-∞) of ISH2 group was 6.01 times higher than that of SMH solution group. The developed ISH2 was suitable for intra-articular injection that may apply to patients in the treatment of rheumatoid arthritis.

BACKGROUND: Pilon fractures are mainly vertical compression violence involving the tibia distal articular surface fracture, especially the high-energy damage Pilon fracture. Pilion fracture is characterized by obvious fracture displacement, different levels of compression, crushing at stem epiphyseal end, unstable height, primary articular cartilage injury and uneven joint surface. Because it is difficult to treat, and holds various complications and high morbidity, it becomes a challenge in the field of orthopedics. Good preoperative planning and design can reduce the occurrence of complications and obtain good clinical treatment outcomes. OBJECTIVE: To explore the clinical effect of three-dimensional printing technology combined with virtual surgery design in the treatment of complex Pilon fractures. METHODS: Eighty-eight patients with complex Pilon fracture at Yulin Orthopedics Hospital of Chinese and Western Medicine from August 2017 to November 2018 were selected and divided into two groups (three-dimensional printing group, n=38; control group, n=50). The three-dimensional printing group was treated with three-dimensional printing technology combined with virtual surgery design, and the control group was treated with conventional surgery. The operation time, blood loss, incision length, one-time successful placement rate, postoperative ankle function recovery and healing were recorded. RESULTS AND CONCLUSION: (1) The three-dimensional printing group was superior to the control group in terms of operation time, blood loss, incision length, one-time successful placement rate, reduction satisfaction (Burwell-Charnley fracture reduction radiology evaluation), functional recovery degree (Mazur ankle joint score) after 12-month follow-up and wound healing (P < 0.05). (2) To conclude, compared with conventional surgery, three-dimensional printing combined with virtual surgery design for treating complex Pilon fractures can shorten the operation time, reduce surgical trauma and blood loss, and achieve satisfactory fracture reduction and functional recovery.

The case of the nodular fasciitis was with a short history and rapid growth speed. The lesion was nodular, not encapsulated. Histologically, the fibroblasts proliferated actively, with some mitoses. The reality of the nodular fasciitis is the proliferation of fibroblasts and myofibroblasts. This disease is a benign lesion. It is very important to make a different diagnosis between this lesion and sarcomas. Ultrasonography and MRI are important assistants in diagnosis of nodular fasciitis. This disease could be effectively treated by local excision with a low recurrence rate and a satisfactory prognosis.
Aged ; Fasciitis ; Head ; pathology ; Humans ; Male ; Neck ; pathology

ObjectiveTo investigate the relationship between HLA-DRB1 alleles and chronic urticaria with positive autologous serum skin test (ASST) in Guangxi Zhuang Autonomous Region.MethodsASST was conducted in 144 patients with chronic urticaria,who were subsequently divided into two groups according to the test result:positive group (n =62) and negative group (n =82).PCR amplification with sequence-specific primers was used to determine the genotypes of HLA-DRB1 alleles in the patients and 199 normal human controls.Chi-square test was performed to analyse the difference in the frequency of HLA-DRB1 alleles between the 3 groups by using the SPSS 13.0 statistical software package.ResultsThere were significant differences in the frequency of HLA-DRB1*01,*1401 and *16 alleles among the patients with positive and negative ASST and the controls (x2 =10.92,Pc =0.032;x2 =35.34,Pc ＜ 0.01 ;x2 =12.69,Pc =0.032).Paired comparison revealed significant differences in the frequency of HLA-DRB1*1401 allele between the patients with positive ASST and controls(RR =17.09,Pc ＜ 0.01 ) as well as between the patients with positive and negative ASST (RR =7.20,Pc ＜ 0.01).ConclusionHLA-DRB1*1401 allele may be,or be linked to,the predisposing gene of chronic urticaria with positive ASST in Guangxi Zhuang Autonomous Region.

Objective To explore the effect of the Internet technology′s application on the hand hygiene compliance of medical staff. Methods Establishing Internet+hand hygiene management model to implement Internet based hand hygiene supervisory and reminding, Internet based hand hygiene publicity and education, and Internet based hand hygiene feedback and communication. This model was applied in Guangdong Provincial Dermatology Hospital to intervene the hand hygiene related activities. Before and after the intervention, the hand hygiene compliance of medical staff in the trial hospital was observed with WHO hand hygiene monitoring table by directly manual observation. Thereafter, the changes of hand hygiene compliance before and after the intervention were compared based on the statistical analysis of test results. Results With the application of Internet+hand hygiene management model, the hand hygiene compliance of medical staff increased from 41.75% (324/776) before the intervention to 72.14% (554/768) after the intervention, and the difference was statistically significant (χ2=145.264, P<0.01). The hand hygiene compliance of both doctors and nurses was significantly increased (doctors: χ2=94.784, P<0.01;nurses:χ2=58.798, P<0.01). In all the five indications, i.e., before patient care, before an aseptic task, after exposure to blood/body fluids, after patient care, and after environmental contact, the hand hygiene compliance was 35.42%(68/192), 63.33%(38/60), 84.38%(54/64), 44.83%(130/290), and 20.00%(34/170) respectively before the intervention;it was 65.38%(102/156), 83.33%(120/144), 95.45%(105/110), 68.52%(148/216), and 55.63%(79/142) after the intervention; and the difference before and after the intervention was statistically significant (χ2=6.305-42.529;P<0.01 or 0.05). Most of the medical staff of the trial department supported this model. Conclusions Internet+ hand hygiene management model could significantly improve the hand hygiene compliance of medical staff and were very popular. And, the model is worth of application in more hospitals.

Objective To approach the application value of diffusion weighted imaging with background suppression (DWIBS) combined with routine MR sequence in differentiating benign and malignant lymph nodes,and assessing therapeutic effect of lympho-genic tumors.Methods 48 patients with cervical lymph node enlargement who were confirmed by pathology and follow up under-went DWIBS and routine MRI examination,malignant lymph nodes were 83,benign lymph nodes were 79.16 patients with malig-nant lymph nodes were rechecked after radiotherapy and chemotherapy,Apparent diffusion coefficient (ADC)values of the solid part for lymph nodes were compared.Results More lymph nodes can be detected in DWIBS than conventional sequence.ADC values of the solid part for malignant lymph node(0.898±0.111)×10-3 mm2/s were lower than that of benign lymph node(1.043±0.106)× 10-3 mm2/s,there was significant difference between them (P<0.05).ADC values of all malignant lymph nodes after treatment (1.205±0.121)×10-3 mm2/s were significantly higher than that of pretherapy (0.883±0.090)×10-3 mm2/s (P<0.05).Conclu-sion DWIBS could more sensitively detect lymph node than conventional MR sequence.ADC value could provide some reference values for differentiating benign and malignant lymph nodes and assessing therapeutic effect.

Objective: To build a comprehensive evaluation system for printable and online materials, and provide reference for the compilation and selection of patient education materials. Methods: Taking Suitability Assessment of Materials (SAM) as frame and combined Patient Education Materials Assessment Tool (PEMAT) and CDC Clear Communication Index, we screened indicator of the evaluation system preliminary and all of them have been adjusted with the language habits and social and cultural characteristics of our country. By Delphi method, 15 experts in related fields were selected to conduct 2 rounds of expert consultation to establish the final indicator system. The weights of the different indicators were also analyzed by Analytic Hierarchy Process (AHP). Results: The indicator system of printable and online patient education materials was consisted of 7 first-level indicators,28 second-level indicators,84 third-level indicators. The positive coefficients and the authority coefficients of the experts were 100% and 0.87 of the two rounds. The coordination factors of the experts in second-level and third-level were respectively 0.362 and 0.255 for the second round. The top three indicators of the first-level indicators were content (0.271 5), behavioral suggestion (0.190 4), and language expression (0.190 4); the highest-level index weight was scientific content (0.095 7), and the lowest was the use of commonly numbers, correct interpretation of numbers and units′ meaning (0.007 0). Conclusion The comprehensive evaluation system for printable and online materials is scientific, comprehensive and easy to operate. It can provide reference for medical worker to prepare and select printable and online materials.

Objective:To investigate the status of professional self-efficacy and its influencing factors among postgraduates in Master of Nursing Specialist(MNS).Methods:Totally 185 postgraduates from 33 universities were chosen by convenience sampling from December 2018 to January 2019 for a cross-sectional survey. Subjects completed a questionnaire covering demographic data, Professional Self-efficacy Questionnaire for Nursing Students, the Chinese version of Proactive Personality Scale and Career Social Support Inventory for Chinese College Students.Results:The score of professional self-efficacy was (92.78±13.22) . Multiple linear regression analysis showed that the sense of achievement in clinical work, proactive personality and career decision support were the influencing factors of postgraduates professional self-efficacy, with an interpretability of 40.2%.Conclusion:Professional self-efficacy of postgraduates is at upper middle level. Schools, hospitals and other relevant institutions should further improve the postgraduates cultivation model, establish high quality clinical practice bases, encourage postgraduates to actively explore career development pathway and provide adequate advices and supports, to improve the professional self-efficacy of postgraduates.