Objective To investigate the clinical value of neutrophil-to-lymphocytc ratio(NLR) in identifying blood stream infection caused by different pathogens and for differentiating coagulase negative staphylococcus(CNS)bloodstream infection and contamination.Methods Medical records of 500 patients who underwent blood culture test and routine blood test at the same time were retrospectively analyzed,blood culture negative group 356 patients,blood culture positive group 144 patients,which included Gram-negative group,Gram positive group,fungi group,CNS bloodstream contamination and mingled group.Collected the results and calculated the NLR at the same time.NLR were applied by t test of each group.ROC curve was used to determine the cut off value of NLR.Results ①Mean values of NLR in negative blood culture,blood stream infection group,CNS bloodstream infection and contamination were 6.12,13.15,10.11 and 6.24.NLR had statistical difference between negative blood culture and blood stream infection group,CNS bloodstream infection group and contamination group (P＜0.05).②Mean values of NLR in and fungi group were 15.33,11.63 and 10.58,respectively.NLR had statistical difference between Gram-positive bacteria group and Gram-negative bacteria group (P＜0.05).NLR had no differences among Gram-positive bacteria (15.33) and Gram negative bacteria (11.63) compared with (10.58) fungi respectively (P＞0.05).③The area under the curve of NLR predicting a positive blood culture,distinguishing Gram-positive bacteria and Gram-negative bacteria,differentiating CNS bloodstream infection and contamination were 0.86,0.60 and 0.75,respectively.The optimal cut off values of NLR for predicting a positive blood culture,distinguishing Gram-positive bacteria and Gramnegative bacteria,differentiating CNS bloodstream infection and contamination were 10.45,7.50 and 8.10 respectively.Conclusion NLR is highly effective in distinguishing blood stream infection and differentiating CNS bloodstream infection and contamination.

Aim To investigate the effect of oleoylethanolamide (OEA),a new PPAR? agonist,on focal cerebral ischemia in mice.Methods Transient focal cerebral ischemia in mice was induced by middle cerebral artery occlusion for 1.5 h. OEA was orally administered either with multiple doses (10,20,40 mg?kg-1) once a day for 3 days before ischemia or single dose (40 mg?kg-1) at 0.5 h before or 1 h before ischemic,the same time of reperfusion or 1 h after reperfusion respectively.Neurological deficit score,infarct volume and brain edema were determined.Results Pretreatment with multiple doses (20,40 mg?kg-1) of OEA before ischemia or single dose (40 mg?kg-1) of OEA at 0.5 h before ischemia or at the same time of reperfusion significantly attenuated neurological deficit score,decreased infarct volume and alleviated brain edema,and the treatment at the time of reperfusion had the most marked effect.Conclusion Oleoylethano-lamide has a dose-and time-dependent neuroprotective effect on the injury in the acute phase of transient focal cerebral ischemia in mice,with effective doses of 20 mg?kg-1 and 40 mg?kg-1 and the optimal therapeutic time point of the same time of reperfusion.

BACKGROUND:Establishing a highly successful, safe, reliable standard spinal cord transection model is the precondition of studying spinal cord injury repair. OBJECTIVE:To evaluate the value of preparing spinal cord transection model in rats and the effects of laminectomy on spinal cord. METHODS: We searched the randomized controled trials involving rat models of spinal cord transection in the databases of PubMed, CNKI, VIP and WanFang. RESULTS AND CONCLUSION:11 randomized controled trials (RCTs) met the inclusion criteria (two in English, 9 in Chinese), and a total of 394 rats were included in the study. There were significant differences in the lower limb motor function scores (BBB scores) within 1-6 weeks after injury (WMD=-12.86, 95%CI-16.10 to-9.62,P < 0.01) and electrophysiological indices within 4 weeks after injury (WMD=15.36, 95%CI 11.36 to 19.36,P < 0.01) between spinal cord hemisection group and laminectomy group. The BBB scores after 6 weeks were not significantly different between these two groups (WMD=-10.28; 95%CI-24.20 to 3.64;P=0.15). There were significant differences in the lower limb motor function scores (BBB scores) within 1-6 weeks after injury (WMD=

BACKGROUND: Animal experimental study on spinal cord injury used injury mode and similarity of clinical spinal cord injury as an important reference index of selecting modeling approach.
OBJECTIVE: To compare the difference among the use of precision impactor, homemade Al en’s impactor, spinal cord compression method and clamping method in rat models of spinal cord injury, and to provide a new basis for the selection of the modeling method of a rat model.
METHODS: PubMed, CNKI, Wanfang and VIP databases were retrieved with computer from Building to June 20, 2015. Eligible literatures were included and analyzed by ADDIS software.
RESULTS AND CONCLUSION: A total of 26 studies met inclusion criteria, containing 599 rats. After analysis of the inclusion studies, the model could be effectively made in each modeling method. The modeling method with effects from best to poor is as fol ows in order: precision impactor, clamping method, homemade Al en’s impactor and spinal cord compression method. According to the lowest mortality, there were precision impactor, homemade Al en’s impactor and clamping method. From the point of view of function and mortality, the use of precision impactor is the best. The use of homemade Al en’s impactor is the most economical. The clamp method could achieve a balance between them.

Objective To analyze the resistant profile and genotypes ,as well as susceptibility to tigecycline in carbapenemase‐producing K lebsiella pneumoniae for better clinical management of such infections .Methods Nine strains of carbapenemase‐producing K .pneumoniae were isolated from clinical specimens during the period from February 2012 to May 2013 in our hospital .Bacterial identification and antimicrobial susceptibility testing were carried out with VITEK 2 Compact automatic microbiological assay systems .The phenotype of carbapenemase‐producing K . pneumoniae was detected by modified Hodges test .The genotype of carbapenemase was identified by PCR method .The susceptibility to tigecycline was tested by E‐test . Results All the 9 strains of carbapenemase‐producing K . pneumoniae were resistant to the 19 antibiotics tested .Modified Hodges test was positive for 7 strains (77 .8% ) .Target band of carbapenemase gene was identified in all the 9 strains of K . pneumoniae ,and all were confirmed as KPC‐2 gene .All the 9 strains were susceptible to tigecycline .Conclusions The resistance of carbapenemase‐producing K .pneumoniae is still serious .Tigecycline has shown good in vitro activity against such strains .

Construction of content management system for mobile library using Drupal can meet the requirements of mobile library which can thus provide better service for readers because of its high integrality, interconnection , intelligibility , convenience , maintainability , and expandability .That is why the whole construction process of content management system for mobile library using Drupal is described in this paper .

Humans ; Lung ; pathology ; Physical Examination ; Pneumoconiosis ; diagnosis ; Thoracotomy

Objective:To explore the predictive value of computed tomography (CT) texture analysis for the recurrence in children with acute pancreatitis (AP).Methods:The clinical diagnostic test was conducted. The clinical data of 56 children with primary AP who were admitted to Wuhan Fourth Hospital from January 2016 to January 2018 were collected. There were 13 males and 43 females, aged from 3.5 to 13.0 years, with a median age of 5.5 years. Based on follow-up in other hospitals, 20 children with recurrence of AP were allocated into recurrence group, and 36 children without recurrence were allocated into non-recurrence group. All the 56 children underwent abdomen plain and enhanced CT scan within 24 hours after first admission. Observation indicators: (1) comparison of clinicopathological features between two groups of children with AP. (2) comparison of CT texture parameters between two groups of children with AP. (3) diagnostic efficacy of clinical features and CT texture parameters. Follow-up using outpatient reexamination and telephone interview was conducted to detect recurrence of AP up to February 2020. The duration of follow-up required more than or equal to 24 months. The Shapiro Wilk test was used to analyze normality of measurement data. Measurement data with normal distribution were repre-sented as Mean± SD, and comparison between groups was conducted using the t test. Measurement data with skewed distribution were represented as M (range) or M ( P25, P75), and comparison between groups was conducted using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was analyzed using the chi-square test. Comparison of ordinal data was conducted using the Mann-Whitney U test. Clinical parameters and CT texture parameters with statistical differences were multivariate analyzed using the Logistic regression model. Receiver operating characteristic curve (ROC) analysis was used to evaluate the predictive efficacy of parameters for recurrence of AP. Results:(1) Comparison of clinicopatholo-gical features between two groups of children with AP: cases with or without complications were 14 and 6 for the recurrence group, versus 7 and 29 for the non-recurrence group, showing a significant difference between the two groups ( χ2=14.021, P<0.05). Cases with minimal, moderately severe or severe disease (severity of disease) were 2, 5, 13 for the recurrence group, versus 19, 11, 6 for the non-recurrence group, showing a significant difference between the two groups ( Z=5.414, P<0.05). (2) Comparison of CT texture parameters between two groups of children with AP: the energy value in the arterial phase on CT examination was 0.186(0.174,0.206)for the recurrence group and 0.413(0.405,0.425) for the non-recurrence group, showing a significant difference between the two groups ( Z=9.413, P<0.05). The energy value and entropy value in the venous phase on CT examination were 0.084(0.078,0.092) and 0.961(0.210,1.720) for the recurrence group, versus 0.135(0.124,0.156) and 0.372(0.210,0.535) for the non-recurrence group, showing significant differences between the two groups ( Z=4.763, 7.243, P<0.05). (3) Diagnostic efficacy of clinical parameters and CT texture parameters: results of multivariate analysis showed the complications, severity of disease, energy value in the arterial phase on CT examination were related factors for recurrence in children with AP, energy value and entropy value in the venous phase on CT examination were related factor for recurrence in children with AP ( odds ratio=0.874, 0.765, 0.837, 0.902, 0.813, 95% confidence interval as 0.802?0.985, 0.581?0.914, 0.753?0.897, 0.862?0.948, 0.765?0.873, P<0.05). Results of ROC analysis showed that that areas under curve (AUC) of complications, severity of disease in the clinical parameters were 0.734 and 0.832, the AUC of single CT texture parameter was 0.811?0.867, the AUC of clinico-pathological parameters combined with CT texture parameters was 0.882. Conclusion:CT texture analysis can early and non-invasively predict the recurrence of AP in children, and the combination of clinicopathological parameters with CT texture parameter has a better predictive efficacy.

The incidence rate of biliary tract cancer is increasing year by year. Systemic therapy is the most important treatment for patients with advanced or unresectable biliary tract cancer. Gemcitabine combined with cisplatin is still the standard first-line chemotherapy, while gemcitabine combined with TS-1 and gemcitabine combined with nab-paclitaxel are also the first-line treatment options. Studies have confirmed that immunotherapy as a back-line treatment has a significant advantage in survival, and the disease control rate of nivolumab is 61% and the median overall survival is more than 1 year. In addition, targeted drugs targeting FGFR2, IDH1/2, HER-2 and other major driving genes of biliary tract cancer also show good antitumor activity, and become research hotspots in the treatment of advanced biliary tract cancer. Summarizing the research progress of systematic chemotherapy, immunotherapy and molecular targeted therapy for advanced biliary tract cancer can provide help for clinical practice.

be diagnosed by imaging examination before operation.The ALT patients with large or symptomatic adrenal lipomatous lesions or preoperatively diagnosed teratoma should be given surgical treatment.