China ; Education, Medical ; Occupational Health

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

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

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.

OBJECTIVE: To study the mechanism and clinical significance of specific immunotherapy (SIT) on the expression changes of GM-CSF and IL-5 in the tissue samples of recurrent nasal polyps. METHOD: Perennial allergic rhinitis patients with recurrent nasal polyps were randomly divided into 2 groups. The experimental group of 19 patients was treated by SIT and standardized treatment (glucocorticoid nasal spray) , and the control group of 17 patients was only treated by standardized treatment (glucocorticoid nasal spray). We measured the expression levels of GM-CSF and IL-5 in the tissue samples of the nasal polyps by ELISA, and compared the results obtained before treatment with expression levels detected at 6 months and 1 year after the treatment. RESULT: The expression of GM-CSF and IL-5 in the recurrent nasal polyps reduced significantly (P < 0.05) in both groups after 6 months and 1 year post-treatment compared with pre-treatment, and the expression of GM-CSF and IL-5 in the experimental group was much lower than that of the control group. CONCLUSION SIT decreases the expression of GM-CSF and IL-5 and reduces the inflammatory reaction in the tissue samples of recurrent nasal polyps.
Enzyme-Linked Immunosorbent Assay ; Granulocyte-Macrophage Colony-Stimulating Factor ; metabolism ; Humans ; Immunotherapy ; Inflammation ; drug therapy ; Interleukin-5 ; metabolism ; Nasal Mucosa ; pathology ; Nasal Polyps ; drug therapy ; metabolism ; Rhinitis, Allergic, Perennial ; drug therapy ; metabolism

Objective To explore the incidence,features and outcomes of in-hospital sudden cardiac death (SCD) in order to determine the predictors of survival. Methods The clinical data of 69 patients with cardiac arrest hospitalized from January 2008 through December 2010 were retrospectively analyzed.Information on genders,age,types of arrhythmia was collected and further analyzed to determine these factors associated with the occurrence and outcomes of in-hospital cardiac arrest. Results The overall incidence of SCD was 47.3 / 100 000 per year and 17.4％ of them.survived at discharge.The occurrence rate was higher in male than that in female (66.7％ vs.33.3％,P ＜0.01 ),whereas difference in gender did not affect the discharge rate ( P ＞ 0.05 ). Survivors from in-hospital cardiac arrest were significantly younger than non-survivors (man:62.57 ± 12.83 years vs.75.56 ± 10.55 years; women:60.36 ± 13.24years vs.69.53 ± 11.72 years,P ＜ O.01 ).From 62 ECG records of SCD patients,the incidence of nonshockable rhythms was higher than that of shockable rhythms.Compare to the non-shockable rhythms,the shockable rhythms brought a higher rate of restoration of spontaneous circulation (ROSC) (54.5％ vs.24.5％,P ＜0.05),whereas survival rates at discharge between two groups were not statistically different ( 18.2％ vs.18.4％,P ＞ 0.05 ).Conclusions Non-shockable rhythms were more common in patients suffering from in-hospital cardiac arrest.Although defibrillation treatment contributed benefit to ROSC among patients with ventricular fibrillation or pulseless ventricular tachycardia,high-quality CPR and post-cardiac arrest care may play a more critical role in the outcomes of in-hospital sudden cardiac death.

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.

Objective:The clinical features, risk factors, and outcomes of coma were analyzed in patients treated with bevacizum-ab combined with chemotherapy This study also aims to increase the awareness on the toxicity of this regimen. Methods:Two cases of coma induced by bevacizumab combined with chemotherapy were reported. Diagnosis, treatment, and relevant literature were reviewed and discussed. Results:Inadequate blood pressure (BP) control was one of the risk factors leading to coma in patients treated with this therapy. The clinical feature of these patients was reversible posterior leukoencephalopathy syndrome (RLPS). Imaging results showed no typical finding. Reinforced supportive treatment including intensive BP control showed satisfactory outcomes. Conclusion:Coma is common in patients treated with bevacizumab combined with chemotherapy. This regimen should be used cautiously in patients with a history of hypertension. BP should be monitored closely and managed promptly during the combination therapy to prevent coma. RLPS-related coma is reversible after appropriate treatment.