Objective To explore the total treatment effect,layered diagnostic treatment effect,the relationship between effect and site of infection and common side effects of commonly used antifungal agents such as itraconazole,Voriconazole,caspofungin and amphotericin B liposome in invasive fungal infection with hematologic malignancies.Methods The clinical data of 117 cases of patients with hematologic malignancies combining with invasive fungal infection hospitalized in our department from Jan,2005 to Aug,2008 were retrospectively analyzed.Results The total effect rates of itraconazole,Voriconazole,caspofungin and amphotericin B liposome were 69.0%(40/58),77.4%(24/31),64.7%(11/17)and 63.6%(7/11)respectivley(P=0.726).In patients with pulmonary infection,the effect rates of the agents were 63.0%(17/27),85.7%(12/14),50.0%(4/8)and 62.5%(5/8)respectively(P=0.283),which itraconazole group was higher than that of the other agents.The effect rates of the 4 groups have similar rates in patients with liver and spleen candidiasis,fungemia and infections with unknown origin.The rates of 6 weeks survival were 86.2%,87.1%,70.6% and 72.7% respectively.The common side effects of itraconazole and Voriconazole were mainly gastrointestinal reaction and mild hypokalemia.There were few patients showed gastrointestinal reaction(12.1%) and hypokalemia(20.7%)in the former.Some individual showed visual abnormity(9.7%)and external vertebral body symptoms(6.4%).caspofungin showed mild toxic and side effects,which was only gastrointestinal reaction(15.4%),while they were common in amphotericin B liposome group,which were Chill and fever(81.8%),hypokalemia(100%),gastrointestinal reaction(18.2%)and liver damage(9.1%).Conclusion The total effect,layered diagnostic effect and 6 weeks survival rates were similar in itraconazole,Voriconazole,caspofungin and amphotericin B liposome in patients with hematologic malignancies combining with invasive fungal infection.

Objective To survey the serum level changes of retinal binding protein 4(RBP4)in newly diagnosed type 2 diabetes,and to explore related factors of RBP4 level.Methods According to body mass index(BMI),95 newly diagnosed type 2 diabetes in Beijing Hospital from April to October of 2002 were divided into obese-diabetic group(BMI≥25),normal-weighted diabetic group(BMI

Objective To investigate the characteristics of lung involvement in microscopic polyangiitis(MPA)patients and its influence on treatment and prognosis.Methods From Jan 2006 to Dec 2007,29 patients were diagnosed with MPA in Peking Union Medical College Hospital.Their clinical data,including clinical manifestations,radiologic and laboratory test results,were retrospectively analyzed.Results The patients included 14 males and 15 females.The mean age was(63.7?10.1)years;28 patients(96.6%)were involved in the lung;20 patients(69.0%)had respiratory symptoms and 15 patients(51.7%)had respiratory signs.Two kinds of patterns were found in radiology:hemorrhage and fibrosis.Seventeen patients(17/27)were hypoxemia in room air blood gas analysis.Five patients(5/18)were diagnosed with pulmonary hypertension by echocardiograghy.Seven patients(7/10)were abnormal in lung function test.Four patients(4/6)were abnormal in BALF.Ten patients(34.5%)were diagnosed with alveolar hemorrhage and 18 patients(62.1%)were complicated with pulmonary infection.Totally 10 patients(34.5%)died,2 patients of diffuse alveolar hemorrhage and 8 of pulmonary infection.Conclusion Most MPA patients have pulmonary involvement and the clinical manifestations vary.There is a high mortality in MPA patients and the main causes are pulmonary infection and diffuse alveolar hemorrhage.

Objective To investigate the association between extraesophageal syndromes of RE and acid reflux.Methods We investigated RE patients in Beijing hospital in the same time period.These patients were diagnosed with reflux esophagitis on endoscopy.In extraesophageal reflux disorders group(32 patients)and the control group(35 patients),extraesophageal reflux disorders symptoms and the control symptoms were evaluated by questionnaire.All patients underwent 24 h esophageal pH monitoring and symptom score evaluation.All patients were treated with esomeprazole.Results The symptoms score in patients whose pH monitoring was positive were significantly decreased after treatments.In extraesophageal reflux disorders group,the effective rate was 86.4%.In control group,the effective rate was 91.7%.Conclusion Extraesophageal syndromes of RE are significantly associated with acid reflux.

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.

0.05).(4)The para-operation pulmonary function indexes(VC,VC%,FEV1)of the patients who had the variation of ECG were significantly lower than those of no-complication patients.(P

Objective To observe the relationship between the levels of plasma VEGF,PAI-1 and the severity of the diabetic retinopathy in type 2 diabetic patients.Methods ELISA method was used to measure the levels of VEGF and PAI-1.Results The level of VEGF was increased in all diabetic patients compared with the normal control group[(17.86?12.25)ng/L],and that of the patients with BDR[(93.41?54.69)ng/L]was higher than that of the patients with NDR[(52.17?21.81)ng/L]and PDR[(61.24?37.55)ng/L].The level of PAI-1 was also increased in all diabetic patients.The increase tendency was more obvious in patients with BDR[(58.29?20.53)?g/L]and PDR[(66.84?23.81)?g/L].Conclusion The damage of the vascular endothelial cell and the impaired fibrinolysis state exist in diabetic retinopathy.So it is very important to measure the levels of VEGF and PAI-1 for the early diagnosis and intervention treatment of diabetic retinopathy.

0.05),but both groups reached a better result when compared with the auto-HSCT group(P

Objective To investigate the use of ERCP in the diagnosis and treatment of children with disease of biliary tract and pancreas.Methods Retrospectively analyze of the clinical data and figures of ERCP treatment for ten cases of disease of biliary tract and pancreas from March to August 2008 in Ruijin Hospital.Results Ten patients were successfully treated by ERCP,and there were no serious complications.Conclusion ERCP is a safe and effective method in the diagnosis and treatment of children with disease of biliary tract and pancreas.

Objective To investigate the difference in influerce of complicated diabetes on the prognosis of kidney transplantation.Methods Analyze the data of 507 times kidney transplantation and clinical tracing.Results Totally 507 patients with kidney function failure had received 539 times kidney transplantation,52 of whom were connected with diabetes[30 male,(51.4?7.1)age;22 female,(51.6?4.9)age],and 16 cases were pre-transplant,36 cases post-transplant.The other 455 cases were non-diabetes[293 male,(38.7?12.3)age;126 female,(43.5?10.1)age].The prevalence of diversified complications in the group with diabetes was all remarkably higher than the other group.There were 9 cases death in the group with diabetes,and 35 deaths in the other group after kidney transplantation;actually the mortality of diabetes group(17.3%,9/52)was 2.45 times as high as the group without diabetes(7.7%,35/455),especially in pre-transplant diabetes group.Another result was that there was no significant difference in the survival period of the dead patients in group with and without diabetes.Conclusion The possibility for the patients who,suffer from kidney function failure with diabetes to get Kidney transplantation postoperative complications is bigger compared with those without diabetes,and the prognosis is poor.To control diabetes more effectively before and after kidney transplantation perhaps can improve the prognosis of them.