Objective To investigate the effects of levofloxacin in the treatment of community-acquired pneumonia and the influence on serum levels of c-reactive protein(CRP)and white blood cell(WBC).Methods 60 patients with community acquired pneumonia from January 2010 to December 2013 in Affiliated Hospital of Ningbo University Medical College were selected and divided into control group(n=30)and research group(n=30),the control group was treated with amoxicillin potassium clavulanate joint azithromycin,the research group was treated with levofloxacin,the clinical effect,clinical symptoms disappear time,CRP,WBC,immune function and safety of two groups were compared.Results There was no significant difference in the efficiency of the two groups.The fever,cough and lung wet rale disappearing time of research group was(3.23±0.48)d,(7.84±1.12)d,(8.26±1.18)d,less than the control group(4.69±0.66)d,(9.30±1.34)d,(9.87±1.43)d,the difference was statistically significant(P<0.05).After treatment,the CRP,WBC of research group was(29.54±4.15)mg/L,(7.11±1.10)×109/L,lower than the control group(36.41±5.17)mg/L,(8.25±1.15)×109/L,the difference was statistically significant(P<0.05).The immune function of research group was improved more significantly than control group,the difference was statistically significant(P<0.05).There was no significant difference in safety between the two groups.Conclusion The effect is reliable of levofloxacin treatment of community-acquired pneumonia,and can decrease the serum level of CRP and WBC.

Objective To investigate the value of detecting HEART score and HEARTS3 score in risk stratification and prognosis of acute coronary syndrome (ACS) in patients with non-ST segment elevation chest pain in emergency department (ED).Methods Clinical data of case-control retrospective study of 775 patients with non-ST segment elevation chest pain in ED were collected from July 2011 to March 2015.The patients were estimated and risk stratification was made with HEART score and HEARTS3 score.After follow-up visiting by telephone for 30 days,outcomes were found to be ACS and myocardial infarction (MI).And the patients were categorized with score into low,intermediate and high risk groups.The correlation between the ACS and risk score in three groups was analyzed.Comparison of capability of performance in predicting 30-day ACS between the HEART score and HEARTS3 risk score.Statistical analyses were performed using SPSS13.0.Enumeration variables were expressed as percentage.For comparison of predictive value of the two sets of scores,area under the receiver operating curve (auROC) was calculated and compared by Z test.Results There were 92 cases with 30-day ACS.The rate of ACS had a trend of increase with increase in HEART score and HEARTS3 score.The patients with higher scores of HEART and HEARTS3,higher incidence of ACS in 30 days.Especially,the high-risk patients with score≥7 of HEART score and≥8 of HEARTS3 score had higher rate of ACS.And there was significant difference in predicting high-risk patients between two sets of scoring (P ＜ 0.05).The HEARTS3 score outperformed the HEART score as determined by comparison of areas under the ROC curve for MI (0.952 vs 0.813;P =0.028),30-day ACS (0.913 vs.0.815;P =0.034).Conclusions HEART score and HEARTS3 score both can be used to evaluate and perform risk stratification for non-ST segment elevation chest pain patients in ED.But HEARTS3 score can more precisely stratify high-risk patients with chest pain for 30-day ACS.

Objective To explore the clinical effect of alprostadil combined with Kudiezi injection in the treatment of posterior circulation ischemic vertigo,and its effect on levels of lysophosphatidic acid (LPA),acidic phospholipid (AP).Methods From October 2015 to October 2017,92 cases of posterior circulation ischemia in the Affiliated Hospital of Medical College were selected and randomly divided into observation group(n =46) and control group(n =46) according to the digital table.The control group was treated with Kudiezi injection,while the observation group was treated with alprostadil combined with Kudianzi injection.The clinical efficacy and LPA,AP levels before and after treatment were compared between the two groups.Results After treatment,the total effective rate in the observation group was 95.65％,which in the control group was 82.61％,there was statistically significant difference between the two groups(x2 =8.622,P ＜0.05).After treatment,Vm and Vs of bilateral vertebrobasilar artery in both two groups were increased more rapidly than those before treatment(observation group:t =14.041,11.124,11.207,10.057,10.925,11.920;control group:t =7.204,7.057,8.145,6.572,6.581,5.481,all P ＜ 0.05).Compared with the control group,the Vm [(34.24 ± 3.04) cm/s,(30.54 ± 3.33) cm/s,(35.42 ± 3.46) cm/s] and Vs[(40.09 ± 5.14) cm/s,(40.24 ± 5.02) cm/s,(43.14 ± 4.97) cm/s] of bilateral vertebrobasilar artery in the observation group were significantly higher (t =7.825,4.581,8.610,7.256,7.017,5.824,all P ＜ 0.05).After treatment,the levels of LPA and AP in the two groups were significantly lower than those before treatment(observation group:t =18.054,17.259;control group:t =17.651,14.254,all P ＜ 0.05).The levels of LPA and AP in the control group [(1.75 ± 0.52) μmol/L,(2.42 ± 0.51) μmol/L] were significantly higher than those in the observation group [[(1.05 ± 0.28) μmol/L,(1.84 ± 0.48) μmol/L] (t =8.571,7.224,all P ＜ 0.05).Before treatment,the number of white blood cells in two groups were (6.23 ±0.54) × 109/L,(6.68 ±0.57) × 109/L,respectively,which after treatment were (6.57 ±0.61) × 109/L,(6.42 ±0.64) × 109/L,respectively,there was no statistically significant difference in leukocyte count between the two groups before and after treatment(all P ＜ 0.05).During the treatment,there was no obvious adverse reaction in the two groups.Conclusion Alprostadil combined with Kudiezi injection in the treatment of circulatory ischemic vertigo has excellent clinical effect,there are no adverse reactions such as leukopenia occurred and the safety is good.