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Objective To evaluate the performance of peripheral blood T-SPOT.TB and cerebrospinal fluid (CSF) interferon (IFN)-γ detection in the diagnosis of tuberculous meningitis (TBM).Methods Among the 182 consecutive cases with suspected TBM in Huashan Hospital from March 2011 to March 2013,30 patients were included in the case group according to the latest diagnostic criteria of TBM.Thirty-nine patients diagnosed with non-tuberculous meningitis were included in the control group.T-SPOT.TB was employed to detect tuberculosis-specific IFN-γ-secreting T cells in the peripheral blood.And IFN-γ in CSF was detected simultaneously by enzyme-linked immunosorbent assay (ELISA) without antigen stimulation.The CSF was collected from 10 patients of TBM group after anti tuberculosis treatment for 4 weeks to observe the dynamic changes.The t-test was used for analysis of continuous variables with normal distribution and Kruskal-Wallis test was used for analysis of variables with abnormal distribution.Results ()f the 30 TBM cases,6 were confirmed cases and 24 were highly suspected cases.The control group was comprised of 12 viral encephalitis,16 suppurative meningitis and 11 cryptococcal meningitis.The positive rate of T-SPOT.TB was significantly higher in TBM group compared with control group (70％ vs 13％,x2 =12.15,P＜0.01).The mean concentration of CSF IFN γ of TBM group was 244.35 pg/mL,which was significantly higher than that of control group 9.48 pg/mL (Z=-4.646,P＜0.01).The CSF IFN-γ was significantly decreased after 4 weeks of treatment (271.02 pg/mL vs 81.36 pg/mL,Z=-3.099,P=0.002).The sensitivity and specificity of peripheral blood T-SPOT.TB in the diagnosis of TBM were 70％ and 87％,respectively.The area under the receiver operating characteristic (ROC) curve of CSF IFN-γ for TBM diagnosis was 0.819; the optimal cut-off point was 81.36 pg/mL; the corresponding sensitivity and specificity were 83 ％ and 85 ％,respectively.Conclusion Both the detection of peripheral blood T-SPOT.TB and CSF IFN-γ are of great importance for the diagnosis of TBM.Dynamic observation of CSF IFN-γ is important for disease monitoring.
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Objective To analyse the clinical feature of infective endocarditis (IE) in recent years.Methods Clinical profiles including age of onset,predisposing factor,clinical manifestation,blood culture and ultrasonic cardio gram (UCG) of 97 cases from Huashan Hospital in the recent 10 years were collected and analyzed retrospectively. Descriptive data were represented as mean ±standard deviation form.Positive rate was represented as percentage form.Fisher's exact test were used to determine two groups' comparison.Results The mean age of the population was (49±17)years.Seventy-three patients (75.3％) had background heart disease,the top 3 of which was rheumatic heart disease in 27 patients (27.8％),congenital heart disease in 23 patients (23.7％) and idiopathic mitral valve prolapse in 18 patients (18.6 ％).The most common clinical manifestation were fever (99.0％),murmurs (95.9％) and anemia (84.5％).Sixty-six patients (68.0％) had positive result of blood cultures. Streptococcus viridans,which was found in 28 patients with native valve endocarditis (42.4 ％),was still the most common pathogen.Staphylococcus,which was found in 18patients (27.3％),had an elevated ratio.Staphylococcus aureus was found in 10 patients (15.2％)and 3 of which were MRSA.Coagulase-negative staphylococcus was found in 8 patients (12.1 ％ ) and 2 of which were MRCNS. Drug-resistant bacteria was increased and pathogens were varied.Vegetations were found in 79 patients (81.4％) by UCG.ConclusionsClinical manifestation,predisposing factor and pathogen have changed in IE patients. Attaching importance to physical examination,multiple-time blood culture and UCG helps the diagnose of IE.
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Objective Orthogonal design was employed to determine the best techniques in processing Carbonized Imperata Cylindrical. Methods UV was used to detect the absorption force and tannis in Carbonized Imperata Cylindrica by different kinds of processing methods. Results The best technique is to bark the drug for 4 minutes at 270 ℃. Conclusion The optimized processing technique was proved to be reasonable by the repeated test.
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Objective To establish optimum processing method for Pollen Typhae Carbonisatus. Method Processing method was studied by orthogonal test and the total flavones were determined by HPLC. Conditions of HPLC used to determine the total flavones were: Waters Nove-Park C18 (150 mm?3.9 mm, 4 ?m), mobile phase: MeOH-THF-0.05%TFT (16∶24∶60), flow rate: 0.8 mL/min, column temperature: 30 ℃, detection wavelength: 360 nm. Results The optimum processing method was skir-baked for 8 min at 210 ℃. Conclusion The optimized processing method is available for the processing of Pollen Typhae Carbonisatus.
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Objective To investigate the chemical constituents in the barks of Populus davidiana. Methods The constituent was isolated by column chromatography and its structure was determined on the basis of chemical and spectral data. Results Compound Ⅰ was identified as (E)-5-hydroxy-2-[3, 4, 5,-trihydroxy-6-(hydroxymethyl)-tetrahydro-2H-pyran-2-yloxy] benzyl 3-(4-hydroxypenyl) acrylate. Conclusion Compound I is a new phenolic glycoside named as davidianoside.
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Objective To investigate the chemical constituents in the barks of Populus davidiana. Methods The constituents were isolated by column chromatography and their structures were determined on the basis of chemical and spectral data. Results Sixteen compounds were isolated and twelve of them were identified as 3?-acetoxyurs-12-en-28-oicacid (Ⅰ), ?-sitosterol (Ⅱ), 4-methoxyphenol (Ⅲ), 3-methoxyphenol (Ⅳ), sakuranetin (Ⅴ), scopoletin (Ⅵ), 2R, 3R-dihydro-7-methoxy-kaempferol (Ⅶ), salicyloyltremuloidin (Ⅷ), tremuloidin (Ⅸ), ?-sitosterol-3-O-glucoside (Ⅹ), salireposide (Ⅺ), and sakuranin ( ⅩⅡ ). Conclusion Compounds Ⅰ, Ⅴ, Ⅵ, and ⅩⅡ are isolated from the plants of Populus L. for the first time.