Objective To explore the influence of combination of Chinese traditional and western medicine continuing nursing care on treatment outcome and quality of life of patients with chronic urticaria.Methods 96 confirmed chronic urticaria patients were selected and divided into the control group and the observation group with 48 patients in each group according to random digit table.The control group was given with routine nursing mode.The observation group received combination of Chinese traditional and western medicine continuing nursing care.The treatment lasted for 12 months.Treatment effect and Dermatology Life Qudity Index (DLQI) evaluation were executed at the end of the 3rd,6th and 12th months.The relapse was inquired 2 months after the intervention by follow-up.Results The total effective rates in the control group and the observation group at the end of the 3rd,6th and 12th months were 75.6％ (34/45),80.0％ (36/45),82.2％ (37/45) and 87.0％ (40/46),91.3％ (42/46),93.5％ (43/46),the results showed significant difference,P ＜ 0.05.DLQI scores at the end of the 3rd,6th and 12th months in the control group and the observation group were (7.82±1.95),(7.04±1.58),(6.56±0.88) scores and (6.85±1.56),(5.71±1.03),(3.42±0.78) scores,the differences were significant,P＜0.05.The relapse interval time was (24.75±5.07) days and (38.20±7.22) days,the difference was statistically significant (P＜0.01).Conclusions Combination of Chinese traditional and western medicine continuing nursing care can significantly improve treatment outcome of chronic urticaria,reduce relapse rate,increase quality of life for patients with chronic urticaria,and it is better than routine nursing care and is worthy of being popularized.

Objective To analyze the laboratory results and chest CT appearances of novel recombinant avian-origin influenza A (H7N9) in discharged patients for understanding the imaging changes.Methods The clinical and imaging data of 4 patients with novel recombinant avian-origin influenza A (H7N9) were collected.The imaging changes and laboratory results were analyzed.Results All patients underwent chest CT examination 2 to 5 times from admission to discharge.The lesions primarily presented as ground-glass opacity (GGO) and mainly located in the inferior lobe of the left lung in 3 cases,in the inferior lobe of the right lung in 1 case,alternating between absorption and progress.GGO was absorbed obviously in about 3 days after treatment and consolidation was progressed after treatment.Consolidation absorption was observed with continue treatment in 1 case.The pulmonary lesions were absorbed obviously in 1 case 7 days after discharge.Synchronous reduction of the absolute values of CD3,CD8,CD4,CD45 were observed in 3 cases and the ratio of CD4/CD8 was normal.Conclusions (1) The areas of pulmonary involvement are large and variable in H7N9.The lesion area and imaging patterns are important for disease prognosis.(2) H7N9 virus infection may causes immunosuppression,decrease of CRP value can predict the improvement of the disease.

0.05).Conclusion The basiccriteria of Rosco Disk Diffusion is suitable for result evaluation of clinical yeast isolates in our hospital. And the stringent criteria is not suitable for result evaluation of Candida albicans.

OBJECTIVE To offer the clinical physician the basis of optimal application of antibiotic,we have investigated the variation of antibiotic resistance and the bacterial spectra in the blood culture.METHODS Blood was cultured in BACTEC9120 of BD.The clinical isolates were identified by API and VITEK-2 of Bio-Merieux of France.Antibiotic susceptive test was done by Kirby-Bauer method and the result which was analyzed by WHONET5.3 and SPSS11.5 software was determined by the NCCLS standard of 2005′s edition.RESULTS Organisms were isolated from the blood specimen of 1468 patients,and there were 743 strains of Gram-positive cocci accounted for 50.7%,565 strains of Gram-negative bacilli accounted for 38.5%.Ninety three strains of fungi accounted for 6.3%.We analyzed the drug-susceptive result of Staphylococcus,Escherichia coli,and Klebsiella pneumoniae during five years,and found that all the antibacterial drug lost efficacy in some degree,except that the sensitivity of the staphylococci to vancomycin was 100%.CONCLUSIONS Gram-positive cocci are the main bacteria in blood culture,the species from which are diversified,and the rate of the drug resistance of some bacteria is high.It indicated that doctors should take more blood culture and monitor the bacteria drug resistant for the data of etiology,so that they can utilize antibiotic more reasonably.

Objective: To explore the relationship between the expression of inflammatory factors and the degree of pain in patients with Kashin-Beck disease after total knee arthroplasty. Methods: Forty-nine patients with Kashin-Beck disease and 55 patients with knee osteoarthritis who underwent total knee arthroplasty in the Department of Orthopaedics, Gansu Provincial People's Hospital from January 2016 to December 2018, were selected, as the Kashin-Beck disease group and osteoarthritis group, respectively, and 50 healthy subjects who underwent healthy physical examination at the same time were selected as the control group. At the 7th day after operation, 3 ml of fasting venous blood was collected from all subjects. The expression levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP) were measured by enzyme-linked immunosorbent assay (ELISA); the visual analogue score (VAS) and knee society score (KSS) were used to compare the pain degree and knee function of each group; correlation analysis between postoperative inflammatory factor levels and VAS, KSS scores in patients with Kashin-Beck disease were studied. Results: The expressions of IL-6 [(78.17 ± 13.28), (60.28 ± 9.92), (9.65 ± 3.12) ng/L], TNF-α [(126.67 ± 15.83), (105.29 ± 12.76), (21.09 ± 5.82) ng/L] and CRP [(11.23 ± 3.41), (8.31 ± 2.54), (2.14 ± 1.01) mg/L] in Kashin-Beck disease group, osteoarthritis group and control group were significantly different (F=12.397, 19.982, 9.167, P < 0.05); and the VAS scores [(5.21 ± 1.44), (2.98 ± 1.03), (0.61 ± 0.22) points], and KSS scores [(60.15 ± 8.91), (72.91 ± 9.19), (93.92 ± 5.73) points] between the three groups were statistically different (F=21.092, 16.743, P < 0.05). The correlation analysis showed that IL-6, TNF-α, and CRP levels were positively correlated with VAS scores in patients with Kashin-Beck disease (r=0.517, 0.498, 0.522, P < 0.05), and negatively correlated with KSS scores (r=-0.509,-0.514, -0.487, P < 0.05). Conclusion After total knee arthroplasty for patients with Kashin-Beck disease, the expression levels of inflammatory factors IL-6, TNF-α and CRP are higher, and they are associated with postoperative pain and knee function recovery.

Objective Parkinson's disease( PD) is a common chronic neurodegenerative disease,with four major symptoms of resting tremor, muscle rigidity, slow motion and postural balance disorder?The pathogenesis of Parkinson's disease is still unknown?A large number of studies suggested that may be the result of the interaction of genetic factors,environmental factors,aging,immune factors,specifically involved in oxidative stress,mitochondrial damage,and other mechanisms?There were 50% patients characterized by tremors,tremor is the most difficult symptoms to treat of PD, but the mechanism is still under controversial, so it ’ s of great significance to understand the generation of PD tremor, which helps to promote the clinical treatment and diagnosis.

Objective To explore the application of low dose of radiation combined with low concentration of contrast medium in the energy spectrum CT of the coronary artery angiography.Methods 60 patients with suspected diagnosis of coronary heart disease were randomly divided into A,B two groups,30 cases in each group.Group A with 350 mg I/mL contrast agent,undergoing conventional CT scanning;Group B using 300 mg I/mL contrast agent,the gems energy spectrum CT scanning with low-dose.Two groups both adopted forward-looking heart switch control scanning mode.After scanning,group A reconstructed conventional images of 40% ASiR sequence,group B rebuilded axial surface images of single energy 65 keV and 40% ASiR sequence,all the reconstruction images were introduced to AW4.6 workstations used for analysis.Double-blind subjective rating was done by two experienced doctors to measure CT values and SD of aortic sinus (AS),left main (LMA),the left anterior descending branch proximal (LAD-p),left circumflex branch proximal (LCX-p), right coronary artery proximal (RCA-p)and pericardial fat,AS the noise (SD),to calculate the signal-to-noise ratio (SNR)and contrast to noise ratio (CNR),to calculate the effective doses of radiation(ED)by recording CTDI and DLP,and to record iodine intake.By using two independent samples t test to compare two groups of patients’the effective radiation doses,iodine intake,the average CT value,SD,SNR and CNR.Results The subjective image quality score differences and coronary measuring section CT values between the two groups had no statistical significance.In the aspects of effective radiation dose,group B reduced about 29% compared to group A,the difference was statistically significant.Iodine intake in group B decreased about 16% than in group A.Conclusion In coronary artery CT imaging, spectral scanning with low dose of radiation and reconstruction images with single energy can effectively reduce the radiation dose and iodine intake,at the same time it can obtain the approximate image quality like conventional scanning.

Objective To evaluate the clinical value of spectral CT monochromatic imaging in improvement of imaging quality of bronchial arteries.Methods We retrospevtively analyzed the chest CT images in 38 patients who underwent the contrast-enhanced spectral CT.These images included a set of 140 kVp polychromatic images and default 70 keV monochromatic images.Using a standard Gemstone Spectral Imaging (GSI)viewer at an advanced workstation (AW4.6),an optimal energy level (in keV)for obtai-ning the best CNR of the bronchial artery could be automatically obtained.The SNR,CNR and objective imaging quality score for these 3 imaging sets (140 kVp,70 keV and optimal energy level)were obtained and compared with one-way ANOVA .Results The optimal energy levels for obtaining the best CNR were (62.58±2.74)keV.The SNR of the 140 kVp polychromatic images,70 keV monochromatic images,and the optimal keV monochromatic images were 1 6.44±5.85,20.96 ±8.32 and 24.91 ±9.91,the CNR were 13.30±5.45,1 7.25±6.97 and 20.67±8.62,and the subjective imaging quality scores were 1.97 ±0.82,3.24±0.75 and 4.47±0.60,respectively,exhibiting significant differences among groups (F =10.1 7,10.1 7 and 1 1 1.12,P <0.00).The optimal monochromatic group was superior to the 70 keV group and the 140 kVp mixed-energy group.Conclusion Monochromatic images at approximately 62 keV in dual-energy spectral CTA yields the best CNR and highest diagnostic confidence for imaging bronchial ar-teries,which may improve imaging quality for imaging bronchial arteries.

Objective To compare the virtual non-enhanced chest CT (VNCT)generated from spectral CT with conventional non-enhanced chest CT in patients with lung disease in terms of CT number accuracy and image quality.Methods A total of 30 patients with lung disease proved by pathology underwent the conventional non-enhanced thoracic CT and contrast enhanced CT with spectral imaging mode in arterial phase (AP)and venous phase (VP).The VNCT images were reconstructed based on the enhanced spectral CT imaging data.The mean CT number,signal to noise ratio (SNR)for the lesions and image quality score were obtained and compared between the true non-contrast CT (TNCT)and the VNCT (including AP and VP)with paired t test.Results The mean±standard deviation for CT number were (38.74±5.17)HU,(39.08±5.07)HU and (38.96± 5.18)HU for TNCT,VNCT at AP and VNCT at VP,respectively, with no statistical difference (P>0.05).All 3 sets of images demonstrated acceptable image quality,even though there were statistically significant differences in the SNR value and image quality score.The mean ± standard deviation values for SNR were 4.74±0.42 with TNCT, 3.79 ± 0.5 1 with VNCT at AP and 3.77 ± 0.39 with VNCT at VP (P <0.05),and the image quality scores were 5.00 ±0.00 with TNCT,4.17±0.65 with VNCT at AP and 4.17±0.53 with VNCT at VP (P<0.05).Conclusion In patients with lung disease,the vir-tual non-enhanced CT images generated from spectral CT provide accurate CT numbers for lesions and acceptable image quality com-pared with the true non-contrast CT.VNCT may be used to replace TNCT to improve work flow and reduce radiation dose.

Objective To investegate the effect of phosphorylated-P38 MAPK(mitogen-activated protein kinase) on the expression of caspase-3 in the substania nigra (SN) of MPTP-induced mouse model of(PD). Methods Mice were randomly divided into MPTP model group, which were treated with MPTP and inhibitor group. Once a day for 5 days; control group was treated with saline and DMSO as much as the model group received per day for 5 days. The behavioral were observed, immunohistochemistry and Western blot for TH, caspase-3 and phosphorylation of P38 MAPK were used to observe the change of positive cell number and the expression level in the SN of midbrain. Results Compared with the mice in control group, the model group showed typical symtoms of PD with decreased numbers of TH-positive neurons and the protein level of TH in SN of the midbrain by about 60% and 65% respec-tively(P<0.01) , the numbers of caspase-3 and phosphorylation of P38 MAPK immunoreactive cells and their protein level in the SN of the midbrain increased markedly (P<0.01). After giving SB203580, the above changes were reduced obviously (P <0. 01). Conclusion In the mouse model of subacute Parkinson's disease induced by MPTP, phosphorylated-P38 MAPK regulated caspase-3 in the SN of midbrain, the specific P38 MAPK inhibitor SB203580 is neurologically oprotective to the mouse model.