1.Clinical analysis of the first case with imported Zika virus disease in China
Yuanbin ZHONG ; Xiaopeng LI ; Lunli ZHANG ; Liping ZENG ; Yichu DENG
Chinese Journal of Infectious Diseases 2016;34(2):72-74
Objective To understand the epidemiological characteristics and clinical features of Zika virus disease,and to improve its prophylaxis and treatment.Methods The first case with imported Zika virus disease in China was retrospectively reported and analyzed.The literature of Zika virus infection in human was reviewed.Results This patient was the first case with imported Zika virus disease in China who presented with typical clinical characteristics and had clear epidemiological history.All the contacts were test negative for Zika virus nucleic acid.Literature retrieval showed evidence of Zika virus propagation in more than 40 countries in Africa,Asia,and Americas.The majority of patients presented with mild symptoms and the main prevention measures included mosquito control and improved awareness of personal protection.Conclusions Human infected with Zika virus often shows recessive infection.Only a small part develop disease and have generally good prognosis with supportive treatment.
2.Experience of integrated traditional Chinese and Western medicine in first case of imported Zika virus disease in China
Yichu DENG ; Liping ZENG ; Wen BAO ; Pinghua XU ; Gongrong ZHONG
Chinese Critical Care Medicine 2016;(2):106-109
Objective Zika virus disease is an acute infectious disease caused by Zika virus transmitted through Aedes mosquitoes. To explore the therapeutic effect of integrated traditional Chinese and Western Medicine for Zika virus disease, the treatment process of the first imported case in China was reviewed. Methods The first imported Zika virus disease in China was admitted to Ganxian People's Hospital in Jiangxi Province on February 6th, 2016, and the patient received isolation treatment for 9 days and cured later. The effect of antiviral treatments including Xiyanping injection was evaluated based on clinical diagnosis and treatment process of the patient. Results A 34-year old male patient was admitted with chief complaint of fever for 9 days, orbital pain and itching rash for 4 days on February 6th, 2016. ① Epidemiological characteristics: the patient was bitted by mosquitoes during his business trip in Venezuela since January 1st, where Zika virus disease was spreading. On January 20th he had dizziness without fever, and the symptom disappeared after taking medicines without details. Paroxysmal dizziness, chills and mild fever without myalgia was experienced on January 28th. On February 3rd small red rash appeared in the neck, spreading to anterior part of chest, limbs and trunk, and the fever, fatigue, nausea was continued, and a new symptom of paroxysmal pain in back of ears and orbits appeared, during which he had not go to hospital. The symptoms relieved on February 4th. He returned to Ganxian County on February 5th, he had yellow stool 3 times with normal temperature, without abdominal pain, and red rash still appeared in the neck. He went to Ganxian People's Hospital on February 6th, 2016. ② Clinical manifestation: the vital signs showed a temperature of 36.8 ℃, a pulse rate of 80 bpm, a respiratory rate of 20 bpm, and a blood pressure of 110/70 mmHg (1 mmHg = 0.133 kPa). It was showed by physical examination that red rash appeared in the neck, and no superficial enlarged lymph nodes were found. Bilateral conjunctival congestion was obvious, physiological reflex existed and pathological reflex was not found. ③ Auxiliary lab test and examination: no abnormal finding were revealed throughout examination and laboratory tests, including routine blood test, liver function, renal function, serum myocardial enzyme, electrolyte, blood sugar, C-reactive protein (CRP), troponin I (TnI), and procalcitonin (PCT), except slight prolongation in activated partial thromboplastin time (APTT, 38.6 s) on February 6th; and slightly dense shadow in left lung in lung CT scan, considering inflammatory changes and slight emphysema (especially in the left lower lung) as well as bilateral renal calculus on February 8th. No significant abnormalities were found in electrocardiogram and B ultrasound test of liver, spleen, and pancreas. ④ Virus confirmation: Zika virus nucleic acid was positive reported by Jiangxi Province Center for Disease Control and Prevention (CDC) on February 7th and Chinese CDC on February 9th, respectively, though Dengue virus were negative reported by Ganzhou CDC on February 6th. Right after the first diagnosis, anyone who had been in close contact with the patient received medical monitoring. ⑤Treatment process: on February 6th, symptomatic treatment was prescribed since admitted into the infectious isolation wards and daily intravenous drip of Xiyanping injection 250 mg was prescribed for antiviral therapy. On February 7th, the patient had no fever, with occasional chills, neck rash was disappeared, orbital pain relieved and bilateral conjunctival hyperemia range was paler and narrowed, and his condition improved. Ibuprofen was administered for defervesce 3 times a day when his temperature reached to 37.5 ℃ at 16:00. On February 8th, the patient had no fever, times of chills was significantly reduced, without myalgia and rash, orbital pain and conjunctival hyperemia further recovered. On February 9th, bilateral eyes slightly tingling, mild conjunctival congestion, no fever chills or other discomfort was found. The chloramphenicol eye drops was prescribed for relieving sting pain with conjunctival congestion twice a day as recombinant human interferon alpha eye drops was out of store. The patient was comfortable from February 11th to February 13th. Blood and urine test for Zika were reported negative by the Chinese CDC and Jiangxi Province CDC. Because all the discharge criteria were satisfied, the patient was discharged on February 14th. Conclusions At present, there is no specific effective drug to prevent and treat Zika virus disease effectually. After receiving symptomatic treatment and antiviral treatments including Xiyanping injection, the patient's symptoms were relieved. Zika virus nucleic acid in blood and urine was negative. The patient was discharged. Combination of traditional Chinese medicine and Western medicine maybe a good method to prevent and treat Zika virus disease.
3.The clinical efficacy of mosapride joint domperidone in treatment of functional dyspepsia
China Modern Doctor 2014;(27):42-44
Objective To observe the clinical efficacy of mosapride joint domperidone in treatment of functional dys-pepsia. Methods In our hospital,from June 2011 to January 2014, seleceted 120 FD patients were randomly divided into observation group and control group,60 cases in each group,the control group took domperidone oral,10 mg/time,3 times/d, took half an hour before meals, once every two weeks. Meanwhile study group combined mosapride oral,5 mg/time, 3 times/d, took half an hour before meals, once every two weeks. Closely observed and recorded adverse reactions during treatment. Results The total efficiency of the study group and control group after treatment was 93.3%,78.3%, the difference was statistically significant between two groups (χ2= 6.273,P<0.05). The observation group and the control group of patients with abdominal pain or discomfort, bloating, early satiety, belching and other clinical symptom score after treatment was significantly lower than before treatment,and the observation group was sig-nificantly lower than the control group's the difference was statistically significanct between two groups (P<0.05). After treatment 3 months, two groups patients were followed's the observation group were followed up 52 cases,the control group were followed up for 50 cases, 6 cases of relapse of the observation group, the control group had 14 cases of re-currence,the difference of the recurrence rate was statistically significant between the two groups(χ2=5.137,P<0.05). Conclusion Mosapride joint domperidone in treatment of functional dyspepsia can improve efficacy, improve detailed clinical symptoms,reduce the relapse rate,worthy of promotion and application.
4.The relationship of course and recurrence after norms antiviral treatment for patients with chronic hepatitis B
Yichu DENG ; Meixiang LI ; Wen BAO ; Juanjuan LIU ; Yunfeng LUO
China Modern Doctor 2014;(25):117-118,121
Objective To explore the relationship of course and recurrence after norms antiviral treatment for patients with chronic hepatitis B. Methods All cases were confirmed by standard use of nucleos drug treatment,after treatment,followed up for 104 weeks; patients after stopping the treatment and contiued to conslidate 1 year, set the control group,patients after stopping the treatment and tiued to consolidate 3 years, as observation group,the recurrence rates and recurrence time were compared. Results The relapse rate of observation group was significantly lower than the control group(χ2=3.877,P<0.05). Control group of 38 cases,31 cases of recurrence after treatment,included 2 cases of recurrence within 2 weeks,25 cases of recurrence within 24 weeks; 4 cases relapsed after 24 weeks.Observation group of 30 cases,18 cases of relapse after discontinuation,1 case relapsed in two weeks,15 cases of recurrence within 24 weeks,2 cases relapsed after treatment 24 weeks. Conclusion The prolonged antiviral therapy can reduce the recur-rence rate of the time,but did not extend the time to recurrence,we recommend patients with chronic hepatitis B nu-cleoside (acid) drug treatment medication should be strictly in accordance with the relevant guidelines,emphasizing long-term medication to maintain efficacy,And standardize management with antiviral treatment.