Objective To discuss the problem of upper respiratory tract infection presenting various clinical manifestations in adults thereby likely making misdiagnosis and to put forth the patients with the symptom of acute abdominal pain as examples in order to caution emergency physicians to avoid misdiagnosis and mistreatment.Methods Data of 58 adult patients with upper respiratory tract infection were collected from January 2010 to December 2011.The chief complain of these patients was acute abdominal pain.After analysis of data including clinical history,symptoms and signs,laboratory findings and medication,patients were divided into two groups post hoc:correctly diagnosed group (group A) and misdiagnosed group (group B).In group A,anti-chill medicine such as tylenol cold tablets (a compositus of paracetamol,pseudoephedrine hydrochloride,dextromethorphan and chlorpheniramine) was given to patients,while in group B,anisodamine (muscarine cholinergic blocker) and antibiotics were given instead of anti-chill medicine.The anti-chill medicine such as tylenol cold tablets would be given to patients of group B when abdominal pain was not released 8-48 hours after treatment.The course of treatment and outcome of patients in the two groups were observed.Results Of 28 patients in group A,27 had abdominal pain relieved or disappeared 2-3 hours after treatment and only 1 patient had abdominal pain lasted 12 hours after treatment.Of 30 patients in the group B,only 2 patients presenting the symptom of acute gastroenteritis got totally relived 2-3 hours after treatment,while the rest of 28 patients did not get rid of abdominal pain,or only had brief period of painlessness after anisodamine injection.Alternatively,8-48 hours later as Tylenol Cold Tablets was given to patients of group B,the abdominal pain was relieved or disappeared after 2-3 hours without recurrence in 2-48 hours.Conclusions Upper respiratory tract infection manifests diversely in adults,and acute abdominal pain could be a main clinical manifestation.Anti-chill medicine,such as tylenol cold tablets,has a noticeably therapeutic effect for acute abdominal pain caused by upper respiratory tract infection in adults,while anisodamine injection makes poor efficacy.

OBJECTIVE:To investigate the curative effects of alfacalcidol soft capsules combined with calaium carbonate tablet on secondary hyperparathyroidism(SHPT)associated with chronic renal failure(CRF).METHODS:55patients were assigned to dialysis group(28cases)and non-dialysis group(27cases),both groups had taken oral alfacalcidol soft capsules in combination with calcium carbonate tablet continuously for3months.Then the changes in serum Ca 2+ ,P 3- ,PTH,AKP and Cr levels were observed.RESULTS:After treatment,serum Ca 2+ concentration was significantly increased(P

OBJECTIVE: To investigate the postoperative application of nasopharyngeal airway (NPA) in rhinogenous obstructive sleep apnea hypopnea syndrome (OSAHS) patients, so that to observe the parameters including vital signs of the patients and evaluatethe value of clinical application and reliability of NPA. METHOD: A total of 216 patients diagnosed as rhinogenous OSAHS were randomly assigned to experimental group (setting NPA, 112 cases) and control group (not setting NPA, 104 cases) according to whether NPA was placed in the nasal cavity postoperatively. ECG, oxygen saturation and hemodynamics were monitored for 24 h postoperatively. The pharyngeal pain and discomfort, low oxygen saturation and hemodynamics were compared between these two groups. The subjective assessment and clinical symptoms were compared between the two groups using visual analogue scale (VAS). RESULT: The experimental group showed better relief of nasal obstruction, nasal pain, headache, dry pharynx, insomnia and pain while taking out nasal packing compared with control group, where the differences were statistically significant (P < 0.01). In the experimental group, the level of LSa2O2 (P < 0.05), HR (P < 0.01), SBP (P < 0.05), DBP (P < 0.01), MAP (P < 0.01) and RPP (P < 0.01) was significantly lower than in the control group. CONCLUSION The postoperative application of nasopharyngeal airway in rhinogenous OSAHS patients could help to keep nasal patency and avoid the upper airway obstruction, which exhibited good safety and compliance. The nasopharyngeal airway can reduce patients' discomfort and improve hyoxemia, ensuring hemodynamic stability.
Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Nasopharynx ; Postoperative Care ; Respiration, Artificial ; methods ; Sleep Apnea, Obstructive ; therapy ; Young Adult

Objective To analyze the clinical, radiological, pathological and microbiological features of invasive pulmonary aspergillosis (IPA) to improve clinical management.Methods Retrospective analysis of 20 pathologically and/or microbiologically confirmed IPA cases in our hospital from January 2005 to August 2008. Results Group A (with underlying diseases) included 13 patients (underlying malignancy in 9 patients, including 5 cases of hematological malignancy, COPD in 2 patients, pulmonary tuberculosis and bronchiectasis in 1 each). Group B (without underlying disease) included 7 patients (2 patients with a long time of fluffy toy contact, another 1 had exposure to moldy rice, and 3 had exposure to polluted water). All these 20 patients had pulmonary invasion revealed by CT imaging. Multiple changes were identified in 16 patients. Bilateral pulmonary infiltrates and/or consolidation were revealed in 7 patients. Multiple nodules were seen in 9 patients. Four patients had solitary lesions, including isolated nodules in 2 patients and segment consolidation in the other 2 patients. Pulmonary cavity without fluid level was found in 8 patients (40.0%). Eighteen cases received antifungal therapy. The overall efficacy rate was 55.6%. The efficacy rate in group A and B was 45.5% and 5/7 respectively. The average time to symptomatic relief was (12.0±2.8) days. The time to lung lesion improvement on CT was (17.4±2.9) days. The time to significant CT improvement was (34.3±9.9) days. The time to the resolution of active lesion was (56.4±6.2) days.Conclusions IPA may occur in immunocompetent patients without underlying disease. Most IPA patients have bilateral multiple pulmonary nodules and cavities on CT. The time to the resolution of active pulmonary lesions is about 6 weeks.

Objective To explore the characteristics of respiratory tract microbiota and its clinical significance in children with protracted bacterial bronchitis (PBB).Methods Twelve children aged from 5 months to 2 years old with PBB (PBB group) and 12 age-matched tracheomalacia(TM) children (TM group) were included in this study,who were admitted into the Respiratory Department of Shenzhen Children's Hospital.Their bronchoalveolar lavage fluid (BALF) samples were collected.Bacterial DNA was extracted from their BALF samples and the 16S rRNA V3-V4 region was sequenced by using Illumina MiSeq TMII system,and the findings were analyzed by bioinformatics methods.Results Principal component analysis revealed the difference in microbiota composition between 2 groups.Compared with TM group,PBB group exhibited lower microbial diversity:the Shannon indices were also 1.683 ± 0.703 and 2.324 ± 0.142 for PBB group and TM group respectively,and the differences were also significant(all P ＜ 0.05),and the Simpson indices were 0.416 ± 0.216 and 0.191 ± 0.025 for PBB group and TM group,respectively,and the differences were also significant (all P ＜ 0.05).The relative abundance of Actinobacteria was significantly lower in PBB group [(0.215 ± 0.228) ％] than that in TM group [(3.028 ± 0.592) ％] (P ＜ 0.01).The proportions of beneficial genera obviously decreased in PBB group,including Lactococcus [(13.464±7.319)％ in PBB group,and (44.784 ± 5.020)％ in TM group,P ＜0.01],Lactobacillus [(0.153 ±0.076)％ in PBB group,and (0.313 ±0.060)％ in TM group,P＜0.01],andArthrobacter [(0.024 ±0.018)％ in PBB group,and (2.970 ±0.584)％ in TM group,P＜0.01].On the other hand,the relative abundances of opportunistic pathogenic genera increased in PBB group significantly,including Haemophilus [(14.319 ± 29.532) ％ in PBB group,and (0.047 ± 0.127) ％ in TM group,P ＜ 0.Ol],Pseudomonas [(10.406 ± 25.439) ％ in PBB group,and (7.228 ± 0.948) ％ in TM group,P ＜ 0.01],and Escherichia [(0.432 ±0.441)％ in PBB group,and (0.055 ±0.035)％ in TM group,P ＜0.01].Conclusion These findings confirmed the existence of respiratory tract microbiotia dysbiosis in PBB,which probably was one of the pathogenetic mechanisms for PBB.