Objective To investigate whether prophylactic antifungal treatment will reduce the incidence of fungal infection(FI)and the mortality in severe acute pancreatitis(SAP).Methods Forty consecutive patients with SAP admitted from January 2008 to December 2009 were divided into prevention group and control group with 20 cases each by random digits table.The patients in prevention group underwent routine therapy plus intravenous fluconazol as prophylactic antifungal treatment,while routine therapy only in control group.The length of hospital stay,the time when FI occurred,the incidence of FI and mortality were compared with each other.Results Compared with control group,the length of hospital stay wag shorter[(40.3±15.4)d vs.(46.5±18.5)d],the time when FI occurred was slewer[(24.5±14.3)d vs. (14.5±12.7)d],the incidence of FI[15.0%(3/20)vs.35.0%(7/20)]and the mortality [10.0%(2/20)vs. 25.0%(5/20)]were lower in prevention group,there were significant differences between the two groups(P<0.05).Conclusion Prophylactic antifungal treatment can shorten the hospital stay,delay the FI occurrence,reduce the incidence of FI and the mortality in patients with SAP.

Objective To investigate the transurethral plasma ion bipolar resection in the treatment of benign prostatic hyperplasia.Methods Clinical data of 135 patients with benign prostatic hyperplasia treated with the transurethral plasma bipolar resection were retrospectively analyzed.Results International prostate symptom score (IPSS) after treatment of urodynamic examination (maximum flow rate,bladder pressure,residual urine) were significantly better than before treatment,the differences were statistically significant (t =11.26,13.12,13.40,39.96,all P ＜ 0.05) ;the difference was not statistically significant in erectile score compared with pretreatment (t =0.74,P ＞0.05).Conclusion The transurethral plasma bipolar resection in the treatment of benign prostatic hyperplasia has good effect,safety,and it is worthy of clinical application.

Objective To observe sputum cytology counts, the levels of nerve growth factor (NGF) and IL-4 in cough variant asthma (CVA) patients and the change of their levels after using glucocorticoids combined with β2-adrenergic agonists one month, and to investigate CVA's characteristics of airway inflammation. Methods Totally 36 patients with untreated CVA were selected, as well as 23 healthy controls. Coughed up sputum cells were obtained and HE strained for differential cell counting in each enrolled patient. In induced sputum's supernatant, the levels of NGF and IL-4 were determined by ELISA.Results Before treatment, CVA patients had a median eosinophils (EOS) percentage of 8%, which was significantly higher than that after treatment (2%, P＜0.05) and in healthy control group (1%, P＜0. 001). The levels of NGF and IL-4 in induced sputum of CVA group were (9. 50 ± 1.69) ng/L and (257.37 ± 53.57) ng/L. After treatment, they were (8.78±1.02) ng/L and (228.60 ±52.93)ng/L in CVA group, (6.98±0.69) ng/L and (166.44±24.75) ng/L in healthy control group. The levels of NGF and IL-4 before and after treatment in the CVA group , as compared with the healthy control group, had statistically significant differences (all P＜0.001). In CVA group before and after treatment, the level of NGF and IL-4 paired difference was significant (P＜0.001). The percentage of induced sputum EOS correlated with sputum supernatant concentrations of NGF and IL-4 (P ＜ 0.01). In induced sputum supernatant, the concentrations of NGF and IL-4 were significant correlated (P＜0.01). Conclusions Glucocorticoid joint long-term β2 agonist inhaled treatment significantly reduced NGF, IL-4 and EOS levels and reduced eosinophilic inflammation, which are closely related with the nerve-immune mechanism, NGF as well as IL-4 participated the inflammation. Induced sputum examination is non-invasive, economical,simple, easily accepted by patients, and repeatable, widely used in clinical.

Objective Analysis the treatment and management of thirty-six out-patients of asthma,in order to share the new experience in the implementation of the strategy.Methods Janaury 2007 36 newly diagnosed or diagnosed bronchial asthma patients in Department of Respiratory Medicine,the first affiliated hospital of China Medical University inhaled budesonide/formoterol dry powder inhalation treatment.Clinical symptoms,rescue medication,lung function and assessment questionnaire score of Asthma Control Test(ACT),Asthma Control Questionnaire(ACQ)were investigated during six months.Results After 6 months' thearopy,the majority of patients showed significant improvement.symptoms and signs got Marked improvement,indicators related to lung function increased in different degrees than before,ACQ score showed a downward trend,with the ease and alleviate symptoms of drug use reduction agreement,ACT score and an upward trend that the condition persistly revived.Conclusion When doctors institut eindividual treatment programme to patients with asthma,they should help patients learn to self-management,so as to make for the condition continued revived and long-term controlled.

Objective To investigate the effects of dopamine combined with norepinephrine on blood lactate and inflammatory factors in elderly patients with severe septic shock.Methods 120 elderly patients with severe septic shock were randomly divided into control group and observation group,60 cases in each group.The control group was treated with dopamine.The observation group was treated with norepinephrine on the basis of the control group at the same time.The treatment was evaluated 48 h after treatment.The changes of heart rate(HR),mean arterial pressure(MAP),central venous pressure(CVP),blood lactate(Lac),urine output,central venous oxygen saturation(SC-VO2),tumor necrosis factor alpha(TNF-α),C-reactive protein(CRP),serum calcitonin(PCT),cardiac function index(CI),peripheral vascular resistance index(SVRI)and extravascular lung water index(ELVWI)were observed before and after treatment for 48h.Results After treatment,the HR of the patients of the two groups decreased,there was no significant difference between before and after treatment in the control group(t=1.551,P=0.062),HR of the observation group were significantly lower than those of the control group and before treatment,the differences were statistically significant(t=15.847,14.960,all P=0.00).The MAP of the control group and the observation group after treatment were higher than those of before treatment(t=32.949,44.344,all P=0.00),and CVP were higher than before treatment(t=12.620,18.959,all P=0.00),urine volume increased significantly compared with before treatment(t=83.213,94.562,all P=0.00),and SC-VO2 were higher than those of before treatment(t=36.589,42.899,all P=0.00),Lac were lower than before treatment(t=15.653,24.016,all P=0.00).The improve degree of HR,MAP,CVP,Lac,urine volume,SC-VO2 of the observation group were higher than those of the control group(t=14.960,15.267,4.857,7.022,20.395,5.704,all P=0.00).The TNF-α levels of the control group and the observation group were lower than those of before treatment(t=13.300,33.004,all P=0.00),the CRP decreased significantly compared with before treatment(t=24.759,24.756,all P=0.00),the PCT were lower than those of before treatment(t=15.235,26.693,all P=0.00),the TNF-α,CRP and PCT of the observation group were decreased more significantly compared with the control group(t=17.470,6.079,10.550,all P=0.00).The CI of the control group and the observation group was higher than before treatment(t=16.050,34.124,all P=0.00),the SVRI were higher than those of before treatment(t=60.357,68.434,all P=0.00),the ELVWI were lower than those of before treatment(t=4.523,8.013,all P=0.00),the CI,SVRI,ELVWI of the observation group were improved more significantly than those of the control group(t=13.176,12.483,2.100,all P=0.00).Conclusion Dopamine combined with norepinephrine can improve the vital signs of patients with severe septic shock,reduce the concentration of lactate in blood,improve the level of inflammatory factors,and heart index.However,due to the subjective factors such as the size of the subject,the lack of research,the future study can increase the sample size to demonstrate the above speculation.

[Objective] To observe the clinical effect of Jiedu Qinghuo Drink on children infection mononucleosis(IM). [Method] Randomly divide 54 cases into treatment group 27 cases and control one 27 cases. The control one was given Ganciclovir, the treatment one added with Jiedu Qinghuo Drink. [Result] The total effective rate was 85.19% for treatment group, and 55.56% for control one, the comparison of both had difference. [Conclusion] Jiedu Qinghuo Drink has good cure effect on children IM.

Bronchial asthma is defined as a chronic inflammatory airway disease in response to a wide variety of provoking stimuli.Over 200 million people in the world are affected with asthma.Because the incidence of asthma appears to be increasing,the importance of proper perioperative management of persons with asthma will also continue to increase.Patients with asthma are thought to be at high risk for pulmonary complications to develop during the perioperative period,and these complications may lead to serious morbidity.So it is very important to control asthma,to prevent and treat pulmonary complications for increasing operational success rate.

The effect of histamine on cardial vascular ,gland,tumor and allergic reaction were reviewed and the development of its antagonist is summarized.

Objective To constitute a correlation with the subjective indicators by investigation of the causes and clinical features in patients with chronic cough.Methods Totally 100 patients with chronic cough were recruited followed a diagnostic program.Airway responsiveness[by methacholine challenge test (MCT)],Leicester cough questionnaire(LCQ),visual analogue scale(VAS),cough score,age,gender and disease duration were all recorded for analysis.Results The top five causes of chronic cough in these patients were variant asthma,post infectious cough,atopic cough,eosinophilic bronchitis and upper airway cough syndrome.LCQ total score was negatively correlated with age and the VAS score(r=-0.239 and -0.470 respectively,all P<0.05),while no difference was found among patients with different causes of disease or gender(F=1.233,t=1.918,all P>0.05)and no correlation was found with BMI(r=-0.029,P>0.05).The physiological and psychological field score in female patients significantly reduced(t=2.174,1.990,P<0.05),and LCQ total score of MCT positive patients obviously reduced than negative ones(t=-2.22,P<0.05).After the treatment of two weeks,LCQ three component field and total score could be improved significantly(all P<0.01).Conclusion Gender and age may have some impact on the quality of life in patients with chronic cough.LCQ,VAS and cough score should be used to assess cough severity and evaluate therapeutic effect in patients with chronic cough.