Objective To investigate the differential diagnosis of pleural effusions with CT density.Methods to meas- ure the CT density of 67 cases of tuberculo-pleural effsions and malignant pleural effusions.Results tuberculo-pleu- rai effsions and malignant pleural effusions are difference.Conclusion CT density of pleural effusions is helpful to dif- ferentiate tuberculo-pleural effsions between malignant pleural effsions.

OBJECTIVE:To investigate the influence of cephalosporins antibiotics on cost and length of hospital stay in pa-tients underwent gallbladder calculus resection,and to provide reference for drug use in clinic. METHODS:A total of 1866 patients underwent gallbladder calculus resection were collected from 9 third grade class A hospitals in Guangxi during 2013-2014. SPSS 22.0 software was adopted to analyze cost and length of hospital stay in patients underwent gallbladder calculus resection. RESULTS:Multi-factor analysis showed that the factors which significantly affected the cost and length of hospital stay were antibiotics,hospi-tals,age,surgery types and disease species (all P<0.01). The antibiotics were divided into the subset 1-4 according to the cost of hospital stay:the subset 1 only contained cefuroxime(9454 yuan);the subset 2 contained noncephalosporins(16199 yuan)and ce-fazolin pentahydrate(17241 yuan);the subset 3 contained ceftazidime(20716 yuan),other cephalosporins(21046 yuan)and cefo-taxime sulbactam(22724 yuan);subset 4 contained cefotaxime sulbactam(22724 yuan),cefoperazone sulbactam(23688 yuan), cefoxitin(24685 yuan)and cefodizime(24698 yuan). The antibiotics were also divided into the subset 1-4 according to the length of hospital stay:the subset 1 only contained noncephalosporins (7.61 d);the subset 2 contained cefuroxime (8.94 d) and cefazolin pentahydrate(9.78 d);the subset 3 contained cefoxitin(13.39 d),cefodizime(13.44 d),other cephalosporins(14.32 d)and ceftazi-dime(14.60 d);the subset 4 included cefoperazone sulbactam(16.03 d)and cefotaxime sulbactam(16.91 d). The higher the subset numbers,the higher the cost of hospital stay or the longer the length of hospital stay;there were statistical differences among differ-ent subsets (P<0.05),while there was no statistical difference among the same subsets (P>0.05). CONCLUSIONS:Cephalospo-rins antibiotics can significantly influence the cost and length of hospital stay in patients underwent gallbladder calculus resec-tion. Antibiotics selection canbe considered comprehensively ac-cording to local medical resources and the patients'demands.

AIM: To examine whether Akt signal pathway proteins, including Akt, NF-?B and I?B?, are activated in kidney tissue of murine chronic graft-versus -host disease (GvHD) lupus nephritis in vivo , and whether prednisone suppres ses activation of them. METHODS: Akt activity and phosphorylated I?B? were detected by Weste rn-blot. Activation of NF-?B was detected by electropheretic mobilit y shift assay (EMSA). RESULTS: Activity of Akt, NF-?B and phosp horylated I?B ? were significantly increased in kidney tissue of murine chronic graft-versus -ho st disease (GvHD) in 8th week and 12th week after monocell injection, respective ly. However, they were no significant elevation in 16th week, when compared with controls. Prednisone treatment significantly prevented the increase in serum an ti-dsDNA antibody level, urinary protein excretion and glomerular cell prolif eration in GvHD mice, indicating the beneficial effects of prednisone on t his model. Prednisone also significantly suppressed the increase in the activities o f glomerular Akt, NF-?B and phosphorylated I?B?. CONCLUSION: T his study provides t he first evidence of marked increase in glomerular Akt-NF-?B signal pathway act ivities in murine chronic graft-versus-host disease lupus nephritis. The benefic ial effect of prednisone on this lupus nephritis model may be partially mediated by the suppression of abnormal Akt- NF-?B activation.

Objective To explore the clinical effect of phalangeal fractures with self-made mini external fixator. Methods From June, 2014 to June, 2017, 16 cases of phalangeal fracture were treated with self-made mini external fixator. In the followed-up periods, the regulating rechecks of X-ray and measurement of interpha-langeal joint activity were determined. The total active movement (TAM), numerical pain ranting scale (NPRS) and morning stiffness was used to estimate the fracture healing and the hand function recovery. Results Pain and ab-normal movement around fracture was found 6 weeks after the operation in 1 case, which had been healed by re-moving the external fixation, open reduction and internal fixation with kirschner wire. The other 15 cases were fol-lowed-up of 48-72 (average, 58) weeks. The fracture has healed. And there was no osteomyelitis, no breakage and loosening of steel needles. The clinical healing time of the fracture was 14 to 16 weeks, with an average of 15.5 weeks. According to the TAM, NPRS and morning stiffness, there was excellent in 11 cases, and good in 4 cases. Conclusion The self-made mini external fixator can maintain the stability after fracture reduction, provide the tension required for the healing of collateral ligament and joint capsule, and meet the need of early functional exer-cise. It is an ideal treatment option for phalangeal fractures.

Objective To evaluate therapeutic effects of wedge resection on male paraurethral duct dilatation following gonococcal paraurethral duct infection. Methods With the aid of high-frequency ultrasound images, 11 male patients with paraurethral duct dilatation following gonococcal paraurethral duct infection were treated with wedge resection. The data were collected, including the surgical duration, amount of bleeding during the surgery, period of wound healing and complications. If the ostium beside the external urethral orifice disappeared within 4 weeks after the surgery, there was no discharge from the ostium with pressure, and no tubular echoic area was observed by high-frequency ultrasound imaging, the patient was considered to be recovered. If none of the above three conditions could be met, the surgical treatment was considered to be ineffective. Results The average surgical duration was 19.19 ± 2.71 minutes(range, 14-23 minutes), the average amount of bleeding during the surgery was 11.09 ± 2.07 ml (range, 8-14 ml), and the average period of wound healing was 14.91 ± 1.45 days(range, 13-17 days). Of the 11 patients, 10 were cured, and 1 showed no response. No complications were observed in any of the 11 patients, and no defects formed in the glans penis. Conclusion Wedge resection is a kind of effective therapy for paraurethral duct dilatation following gonococcal paraurethral duct infection in males.

Objective To verify the change of the anxiety and depression of patients anteriorposterior treatment at paraurethral duct dilitation after gonococcal infection of paraurethral duct.Methods Twenty-eight patients of paraurethral duct dilatation after male gonococcal infection of paraurethral duct were enrolled,and the patients were treated in the Department of Dermatology and Venerology,the First People's Hospital of Changshu City.The anxiety and depression of patients anteriorposterior treatment were assessed and compared with Hamilton depression scale and Hamilton anxiety scale.Results The total scores of Hamilton depression scale and Hamilton anxiety scale before treatment were positively correlated with course of disease (r =0.481,P =0.0095;r =0.549,P =0.0025).The total scores of Hamilton depression and anxiety before treatment were from 1 to 31 (18.9±7.5) and from 4 to 30 (14.9±6.8).The symptoms of depression and anxiety appeared in 11 patients and 15 patients respectively.The total scores of Hamilton depression andanxiety after treatment were from 0 to 8 (4.3±1.7) and from 0 to 8 (3.3±1.7).There was no symptom of depression and anxiety.The difference of the total score of Hamilton depression and anxiety before and after treatment had statistical significance (t =12.270,P＜0.001,t =10.626,P＜0.001).The difference of positive rate of depressive and anxious symptom before and after treatment had statistical significance too (x2 =9.05,P=0.003;x2 =13.06,P=0.000).Conclusions The sequelae of gonococcal paraurethral duct infection in male paraurethral duct dilatation can result in the anxiety and depression of patients,which should be treated.Effective therapy can relieve or cure the anxiety and depression of patients without the assistance of psychotropic drugs.

Objective:To investigate ultrasonographic manifestations of gonococcal infections of the penile skin and accessory glands in men, and to assess their clinical significance.Methods:From January 2014 to January 2021, male patients with gonococcal infections of the penile skin and accessory glands were collected from Department of Dermatology, Changshu No.1 People′s Hospital. The diagnosis had been confirmed by laboratory examinations, and these patients had not received relevant treatment. The real-time ultrasound imaging system SIEMENS ACUSON X300 was used to examine the penile skin and accessory gland lesions infected with Neisseria gonorrhoeae, with the probe frequency ranging from 7.5 to 15 MHz. Patients with tubular anechoic fluid-filled areas on the high-frequency ultrasound images received a single dose of intramuscular ceftriaxone (1 g) ; those with oval-shaped anechoic fluid-filled areas on the high-frequency ultrasound images received incision and drainage followed by intramuscular injection of ceftriaxone at a dose of 1 g once a day for 5 consecutive days; those with hypoechoic or mixed echoic areas on the high-frequency ultrasound images received intramuscular injection of ceftriaxone at a dose of 1 g once a day for 5 consecutive days, and if the nodules did not regress after 1-month treatment, local resection would be performed. One month after the treatment, the patients were followed up, and the efficacy was evaluated. Results:A total of 32 male patients with gonococcal infections of the penile skin and accessory glands were collected. They were aged 28.54 ± 3.27 years, all had a history of non-marital sexual contact, and the duration from non-marital sexual contact to the onset of symptoms was 4.45 ± 1.03 days. The disease course was 8.64 ± 1.87 days. Lesions were all solitary, and located at the external urethral meatus in 16 cases (50.00%) , at the glans penis in 7 cases (21.88%) , beside the foreskin frenulum in 5 cases (15.62%) , and at the penile raphe in 4 cases (12.50%) . Sixteen patients (50.00%) presented with sinus-like lesions, 9 (28.13%) with abscesses, 7 (21.87%) with nodules, and all had tenderness on palpation. High-frequency ultrasound examination showed tubular anechoic fluid-filled areas in 16 cases (50.00%) , oval-shaped anechoic fluid-filled areas in 7 cases (21.88%) , hypoechoic areas in 5 cases (15.62%) , and mixed echoic areas in 4 cases (12.50%) . Gonococcal infections involved the cavernous body of the urethra in 16 cases (50.00%) , cavernous body of the penis in 5 cases (15.62%) , and subcutaneous tissue of the penis in 11 cases (34.38%) . After the treatment, all the patients were cured.Conclusion:High-frequency ultrasound can be used in the assessment of skin lesions and selection of treatment regimens for male patients with gonococcal infections of the penile skin and accessory glands.

OBJECTIVE To study the quality grade stand ard of the premature Forsythia suspensa . METHODS A total of 138 batches of premature F. suspensa were collected from the main producing areas of F. suspensa in China. According to 2020 edition of Chinese Pharmacopoeia ，the contents of impurities ，moisture，ethanol-soluble extract ，volatile oil ，forsythin and forsythoside A in the premature F. suspense were determined ，and the qualified samples were screened. AHP-PCA mixed weighting method was used to give comprehensive weight to the indicators （except for the limit of impurity ）. The comprehensive score of the samples was calculated. The suggestions on the quality grade division of premature F. suspensa were put forward according to cluster analysis of K-mean value. RESULTS & CONCLUSIONS The contents of impurities ，moisture，ethanol-soluble extract ，volatile oil ，forsythin and forsythoside A in the premature F. suspense were 0-7.80％，1.60％-8.18％，13.13％-61.60％，0.21％-3.47％，0.02％-2.15％ and 0.79％-14.04％，respectively；average contents of them were 1.24％，4.97％，34.88％，2.01％，0.42％，6.86％，respectively. Totally 47 batches of 138 batches were qualified in all indexes. It is suggested that the quality grade of the premature F. suspense can be divided into three grades ：in first grade of F. suspense ，the contents of volatile oil ，forsythin，forsythoside A ， ethanol-soluble extract and moisture were ≥2.40％，≥0.59％，≥8.34％，≥38.66％ and ≤4.99％，respectively；in second grade of F. suspense ，the contents of above indicators were ≥2.26％，≥0.41％，≥7.47％，≥32.58％ and ≤5.33％，respectively；in third grade of F. suspense ，the contents of above indicators were ≥2.15％，≥0.32％，≥4.60％，≥31.52％ and≤7.23％，respectively.