Objective:To:investigate the curative effects and cost of sequential treatment of children communityacquired pneumoni(CAP) with azithromycin. Method:118 cases of CAP from this hospital were divided into two groups: sequential azithromycin therapeutic group (Group A) and iv ceftazidime group (Group B). Their clinical effect was observed and cost minimization analysis was carried out. Result:The total costs were 612?7. 3 yuan and 819?8. 2 yuan(P 0.05) in Group A and Group B respectively. Conclusion: The sequential azithromycin scheme is a better one to treat CAP.

Tuberculous meningitis is an important global medical problem which gives rise to high morbidity and mortality. It is the most severe form of extrapulmonary Mycobacterium tuberculosis. Comprehensive prevention effort, prompt diagnosis and rational treatment are all keys to improving treatment outcomes; yet many unsolved problems remain. On the other hand, the new problems, such as HIV co-infection and drug-resistance are posing important challenges. This review outlines the epidemiology, pathogenesis, diagnosis, management and prognosis of tuberculous meningitis. We mainly focus on research carried out in the recent decades, giving special attention to the work done among the Asian populations
Tuberculosis, Meningeal

China ; Education, Medical ; Occupational Health

Objective To study the effectiveness and safety of therapeutic mild hypothermia in patients successfully resuscitated from cardiac arrest using a meta-analysis.Methods We searched the MEDLINE (1966-April 2012),OVID (1980 to April 2012),EMBASE (1980 to April 2012),Chinese bio-medical literature & retrieval system (CBM) (1978 to April 2012),Chinese medical current contents (CMCC) (1995 to April 2012),and Chinese medical academic conference (CMAC) (1994 to April 2012).Studies were included (1) the study design was a randomized controlled trial (RCT); (2) the study population included patients successfully resuscitated from cardiac arrest,and received either conventional post-resuscitation care with normothermia or mild hypothermia; (3) the study provided data about good neurologic outcome and survival till hospital discharge.Relative risk (RR) and 95％ corfidence interval (CI) were used to pool the effect.Results The study included four RCTs with a collected total of 417 patients successfully resuscitated from cardiac arrest.Compared to conventional post-resuscitation care with normothermia,patients in the hypothermia group were more likely to have good neurologic outcome (RR =1.43,95％ CI 1.14 ～ 1.80,P =0.002) and were more likely to survive till hospital discharge (RR =1.32,95％ CI 1.08 ～ 1.63,P =0.008).From all over the studies there was no significant difference in reported adverse events between the normothermia and hypothermia group (P ＞ 0.05).There did not exist heterogeneity and publication bias.Conclusions Therapeutic mild hypothermia improves neurologic outcome and survival in patients successfully resuscitated from cardiac arrest.

Animals ; Aorta ; metabolism ; pathology ; Atherosclerosis ; etiology ; metabolism ; pathology ; Cholesterol, Dietary ; Male ; Matrix Metalloproteinase 2 ; metabolism ; PPAR gamma ; agonists ; Rabbits ; Random Allocation

Objective To investigate the protective role of carbon monoxide releasing molecule-2 (CORM-2) in post-resuscitation myocardial dysfunction (PRMD) in rat models of cardiopulmonary resuscitation (CPR).Methods Cardiopulmonary resuscitation model was established after cardiac arrest induced by ventricular fibrillation.Male healthy Sprague-Dawley (SD) rats were randomly (random number) divided into 4 groups according to random number table:control group,CORM-2 group,inactive CORM-2 (iCORM-2) group and Sham group,in which the equal volume (1 mL) of 0.2％ DMSO,50 μmol/kg CORM-2,50 μmol/kg iCORM-2 and 0.2％ DMSO were respectively administered into the rats of these groups after resuscitation.The ejection fraction (EF) of left ventricle and myocardial performance index (MPI) were measured to detect the myocardial function by echocardiography at 12 hours after resuscitation.Mitochondrial respiration was assessed with Clark oxygen electrode at the same time.Western blot was used to determine the ratio of mitochondrial cytochrome c (cyt c) to cytoplasmic cyt c as well as caspase-3 level.Multiple comparisons were made by analysis of variance.Results Compared with the control group,higher EF and MPI,higher state Ⅲ respiration rate and respiratory control rate (RCR) of mitochondria,and decreased ratio of mitochondrial cytc/cytoplasmic cyt c and lower caspase-3 level were observed in the CORM-2 group (P ＜ 0.05).However,there were no significant differences in above biomarkers found between iCORM-2 group and control group (P ＞ 0.05).Conclusions The CO released from CORM-2 might improve mitochondrial respiration and PRMD by inhibition of myocardial apoptosis via a mitochondrial pathway.

Objective To investigate the effect of aspirin on the incidence of thromboembolism in hypertensive patients associated with paroxysmal atrial fibrillation.MethodsFour hundred hypertensive patients with paroxysmal atrial fibrillation (mean age 59 years) free of thromboembolic events were randomized assigned to receive aspirin (0.3 g/d) or placebo. Cerebral thromboembolism,including transient ischemic attack and embolism of peripheral arteries were defined as primary outcomes. Event-free survival curves were estimated by Kaplan-Meier curve. Results During 3.6 years follow-up,primary outcomes occurred in 61 patients (4.3% per year). Aspirin significantly reduced the incidence of primary outcome as compared with placebo group( 9.0% vs 21.5%,P

Object To research on genetic relationship among the main populations of Salvia miltiorrhiza Bge. and the genuineness of the herb. Methods From main distributed places, 44 samples (including nine populations) were analyzed by RAPD. The data of amplified bands were analyzed by the software NTSYS-pc and AMOVA. Results (1) From more than 100 primers, 11 primers producing polymorphism and reproduceable bands were selected, 129 bands were amplified. (2) The percentage of polymorphic bands within different populations were 20.9%-55.0%. (3) The cluster map including all samples were obtained by UPGMA. In the map, there were six cluster groups and three individuals outside the groups. The branch with five samples of Zhongjiang Sichuan population were far from other samples in genetic distance. (4) According to the distribution provinces five groups were divided in genetic variance analysis. Genetic variance 80.44% existing within population, 8.29% among populations and 11.27% among groups. Conclusion (1) The genetic diversity within population of S. miltiorrhiza is plentiful. (2) The seeds of the cultivated population in Shandong and Henan Provinces come from the wild ones of same places. The cultivated plants lack artificial selection. The decrease of chemical compound is mainly due to the undesired condition of cultivating. (3) The genetic differentiation among the populations from different provinces is unbalance. Two population from Zhongjiang Sichuan and Chengde Hebei are far from the other population. (4) The genuineness of Radix Salviae Miltiorrhizae should be decided according to modern evaluation system. The herbs from some places of Shandong and Henan should be genuine ones.

ObjectiveTo explore the practicability of combined surgical treatment for the patients with Hepatocellular Carcinoma(HCC) complicated with Portal Hypertension(PH).MethodsThe clinical data of 43 patients withHCCcomplicatedwithsignificantesophagealvaricesandhyperspleniawereanalyzed retrospectively.All patients were diagnosed with esophageal varices and hypersplenia of different degrees, 14 of them had severe esophageal varices, the other 29 patients had moderate esophageal varices.Firstly all patients underwent splenectomy, 18 of them had selective portoazygous devascularization in addition.After that the patients received hepatectomys ,with local excision or segmentectomy as the major operation methods.Results All patients received hepatectomy combined with splenectomy treatment.There was no perioperative mortality, but 12 patients had complications after the surgery.Over seventy percents patients(33/43)accepted regular followup.Among these 33 patients,the 1-year and 3-year survival rates were 90.9％ (30/33) and 63.6％ (21/33)respectively.Eleven patients died of tumor recurrence.Four patients had upper postoperatively gastrointestinal hemorrhage.ConclusionHepatectomy combined with splenectomy didn't increase the mortality in the patients with HCC complicated with PH.The combined surgery might reduce the incidence of severe complications, such as postoperative bleeding.We believe the combined surgical treatment is feasible for this group of the patients.

ObjectiveTo observe effects of ginkgo bilobate extract injection on the hemorheology,blood lipid and c-reactive protein in serum of patients with cerebral infarction. Methods62 cases patients with cerebral infarction were randomly divided into two groups by means of random number table. Two groups were both given routine treatment. The control group was treated with 20ml compound salvia injection, which was added to 250 ml normal saline, once a day, continuous therapy for 14 days, and the treatment group was treated with 20ml ginkgo bilobate extract injection, which was added to 250 ml normal saline, once a day, continuous therapy for 14 days. The clinical symptoms were observed, hemorheology related index, level of blood lipid and c-reactive protein were detected before and after the treatment. ResultsCompared with the control group,hemorheology related index decreased significantly in the treatment group, especially whole blood viscosity ( 1.57±0.28) mpa ·s (P＜0.01). Blood reduced viscosity (13.95 ± 2.07) mpa ·s, erythrocyte aggregation index (1.37±0.12) , hematocrit (42.36±8.16) were also decreased significantly (P＜0.05) .Triglyceride (TG)(1.23±0.12) mmol/L、 cholesterol (TC) (4.29±1.17) mmtmol/L、 low density lipoprotein cholesterol (LDIL-C)(2.31± 0.39) mmol/L and c-reactive protein ( 10.48 ±- 3.82) mg/L in serum in the treatment group were lower than those of the control group (P＜0.01 orP＜0.05) , high density lipoprotein cholesterol (HDL-C) ( 1.78±0.76) mmol/L in serum was higher than that of the control group (P＜0.01) .The total effective rate of the treatment group and the control group was 87.1％ and 67.7％ respectively, there was a significant difference (x2=3.553, P＜0.05). Conclusion The ginkgo bilobate extract injection can protect cerebral infarction from injury,which may be related with its action on regulating the blood viscosity and level of blood lipid.