Objective To explore the clinical features of pulmonary tuberculosis complicated with DM and related factors. Method The manifestations of 87 newly diagnosed PTB patients with type 2 DM(DM-PTB group) at two hospitals in Tianjin during October 2003 to October 2004 were compared to 88 PTB patients without DM who were randomly choosen from the same hosipital.The factors related to sputum-positive TB or cavity were explored through unconditional logistic regression model. Results DM-PTB patients showed significanly lower frequencies of cough(66.7% vs 83.0%),toxicity symptoms(37.9% vs 62.5%) and haemoptysis(16.1% vs 33.0%) than those of PTB group.Positive-sputum(63.2% vs 34.1%),cavity(56.3% vs 13.6%),wide lesions and bilateral lesions on chest radiographs was more common in DM-PTB group than in PTB one.Introversion(OR=1.582, 95%CI:1.063 ～2.355),type 2 DM(OR =2.186,95% CI:1.082 ~4.420)and cavity(OR =2.793,95% CI:1.308 ～5.964)were factors independently associated with positive-sputum TB.The factors related to cavity included diabetes(OR=14.199,95%CI:5.376~ 37.501),cough,postive sputum and lore-up lobe lesion.Conclusion This study confirmed that clinical manifestations and chest radiographs of PTB patients complicated with type 2 DM significantly departed from the typical presentation.Type 2 DM seems to have a negative effect on postive-sputum and cavity.So it should be alarmed that DM-PTB patients who tend to have untypical clinical symptom and higher rate of positive sputum become the reservoirs of infection to cause the transmission of TB.

Objective To investigate the effect of insulation during surgery on the prognosis of hy-potherrnic trauma patients. Methods Trauma patients (80 cases) with injury severity score (ISS) of 16～40 and anal temperature < 36℃,were selected and randomly divided into the insulation group and the control group with 40 cases in each group.Both operations went along under room temperature. The in-sulation group keep anal temperature ≥ 36 ℃,while the control group received no insulation interven-tion.The palinesthesia time,time length of hospital stay,infection of wound and fatality were observed in the two groups. Results The palinesthesia time and time length of hospital stay dramatically shortened,the infection rate of Wound and fatality reduced in the insulation group compared with that of the control group (P<0.05). Conclusions Insulation during surgery can significantly shorten the palinesthesia time and time length of hospital stay,reduce the infection rate of wound and fatality.

Objective To explore influence of perioperative protection from hypothermia on surgical site infection (SSI) in patients undergoing gastroenteritic operation. Methods A retrospective study was carried out in 1536 patients undergoing gastroenteritic operation in general surgery department of our hos-pital.Patients (764 cases) admitted before July 2006 were set as the control group,while those after July 2006(772 cases) were set as the observation group. The observation group received a series of measures for protection from hypothermia besides of routine perioperative nursing.The control group only adopted routine perioperative nursing.The SSI rate was compared between the two groups. Results The SSI rate of the observation group was lower than that of the control group(P < 0.01 ). Conclusions Incidence of periop-erative hypothermia in patients undergoing gastroenteritic operation can increase the SSI rate.Appropriate measures for protection from hypothermia can prevent the incidence of hypothermia as well as SSI.

Objective To know the influence of heat preservation intervention on temperature among aged patients who had accepted abdomen surgery. Methods Divided 40 aged patients into the heat preservation group and the routine temperature group, there were 20 cases in the each group. Heat preservation intervention were used in the heat preservation group, while the routine nursing cares were used in the routine temperature group. Compared the incidence rate of shivering and the changing of temperature during the course of operation between the two groups. Results There was no significant difference in the heat preservation group about changing of temperature during the course of operation, while the difference in the routine group was significant. The incidence rate in the shivering in routine group was significant higher than that of in the beat preservation group. Conclusions It is necessary for aged patents about heat preservation during the operation, which can avoid low body temperature and promote satisfactory prognosis.

Objective To investigate the effects of oral calcitriol pulse therapy combined with resin adsorption in treatment of severe secondary hyperparathyroidism.Methods Thirty-two hemodialysis patinents were randomly divided into three groups:oral calcitriol pulse therapy(CP group,12 cases),oral calcitriol pulse therapy combined with resin adsorption group(CP+RA group,10 cases),and resin adsorption group(RA group,10 cases).Serum immunoreactive parathyroid hormone(iPTH),albumin,urea,creatinine,hemoglobin levels were detected before treatment and 1,2,3 months after treatment respectively.Serum calcium and phosphorus levels were also detected every half a month.Results The clearance rate of resin adsorption Was decreased significantly every time(P<0.05).Serum iPTH in CP+RA group decreased significantly 2 months after treatment.Serum iPTH3 months after treatment in CP+RA group[(598.50 ±317.45)ng/L]was less than that in CP group[(1008.67±436.85)ng/L]and RA group[(1464.60±411.27)ns/L](P<0.05).Conclusion Oral calcitriol pulse therapy combined with resin adsorption can clear iPTH safely and effectively.

OBJECTIVEObserve and analyze the informations of western medicine and traditional Chinese medicine in patients with coronary heart disease (CHD), in order to provide reference for clinical treatment.

METHODSelect patients with CHD in diagnosis of the first place in 17 hospitals, drug informations of these patients were analyzed using frequency method and association rules.

RESULTIn 84 697 patients,there were 47 564 males and 32 882 females. The median age was 71 years old, 76 172 patients have medicine records, including 278 kinds of western medicine and 331 kinds of traditional Chinese medicine. Aspirin was the most common used western medicine (51 132 patients, 67.08%), followed by isosorbide dinitrate, clopidogrel etc. The most common used traditional Chinese medicine was danhong injection, followed by shuxuetong injection. After classified the drugs, at the forefront of western medicine were antiplatelet drugs, nitrates drugs, statins, beta blockers, calcium antagonists, ACEI; the most used in traditional Chinese medicine was injection of blood-activating and stasis-resolving, followed by oral preparations of blood-activating and stasis-resolving medicine, Fuzheng class oral medicine, purgation medicine etc. After association rules, combination therapy among western medicine was the most common, combination of western medicine with blood-activating and stasis-resolving was very commonly, especially antiplatelet drugs and nitrates drugs.

CONCLUSIONWestern medicine in the treatment of patients with CHD was in accordance with the guidelines recommend, but with the lower utilization rate. Traditional Chinese medicine has become an important method for the treatment of CHD, promoting blood circulation and removing blood stasis is an important part of traditional Chinese medicine treatment in patients with CHD.

Adrenergic beta-Antagonists ; therapeutic use ; Adult ; Aged ; Aged, 80 and over ; Animals ; Aspirin ; therapeutic use ; Combined Modality Therapy ; Coronary Disease ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; therapeutic use ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Nitrates ; therapeutic use ; Platelet Aggregation Inhibitors ; therapeutic use

AlM:To observe the changes of binocular vision in V-pattern exotropia children before and after surgical correction, and the effect of training in reconstructing the binocular vision after surgical corrections.METHODS: Sixty V-pattern exotropia children were enrolled in this study and were divided into three groups according to their age:group A (4~6 years old), group B (7~9 years old), and group C (10~12 years old), 20 cases for each group. Patients received routine refraction and ophthalmic examinations. Distance and near deviation were measured by prism-covering method and synoptophore. The simultaneous perception and fusion were examined with a synoptophore, and the stereacuity was measured with stereograms ( Titmus) . The children who didn’t reconstruct binocular vision function 1wk after surgery received binocular vision training. The data were recorded before and 1 , 2, 4, and 8wk after surgery. RESULTS: Binocular vision significantly improved among the children after surgery in group A and B ( P<0. 05 ) . Significantly divergence showed between group C and the other groups 1wk after surgery ( P < 0. 05 ). Binocular vision of the three groups all significantly improved 8wk after surgery, with no significant differences (P>0. 05). CONCLUSlON: V - pattern exotropia children can benefit from early surgical correction and training after surgery in reconstruct binocular vision.

OBJECTIVETo evaluate the efficacy and safety of etanercept plus Tripterygium wilfordii polyglycoside (TWP) in elderly patients with active rheumatoid arthritis (RA).

METHODSTotally 46 elderly patients with active RA were randomly assigned to the treatment group (22 cases) and the control group (24 cases). All patients received subcutaneous injection of etanercept, 25 mg each time, twice per week. The dosage was reduced to once per week 3 months later. Patients in the treatment group took TWP Tablet (10 mg each time, three times per day), while those in the control group took methotrexate (MTX), 10 mg each time, once per week. The whole course lasted for 24 weeks. Patients' rest pain, tender joint number, swollen joint number, health assessment questionnaire (HAQ), patients' global assessment, physicians' global assessment, erythrocyte sediment rate (ESR), C reactive protein (CRP), rheumatic factor were assessed at week 0, 4, 8, 12, and 24. The curative effect was statistically evaluated by the United States Institute of Rheumatology ACR20, ACR50, and ACR70 improvement criteria. Meanwhile, any adverse event was recorded and evaluated.

RESULTSTotally 41 completed the trial, and 5 dropped off (3 in the treatment group and 2 in the control group). Compared with the control group, there was no statistical difference in ACR20, ACR50, or ACR70 in the treatment group (P > 0.05). Compared with before treatment in the same group, there was some improvement in tender joint number, swollen joint number, visual analogue scale (VAS) for patients' global assessment, VAS for physicians' global assessment, ESR, CRP, and HAQ between the two groups, showing statistical difference (P < 0.05). Compared with the control group in the same phase, there was no statistical difference in the treatment group (P > 0.05). There was no statistical difference in the occurrence of adverse events between the two groups.

CONCLUSIONSEtanercept plus TWP could achieve equivalent therapeutic effect to that of Etanercept plus MTX. The two regimens could improve clinical signs, symptoms, and QOL related to RA. They were well tolerated in the treatment of elderly patients with active RA.

Aged ; Antirheumatic Agents ; therapeutic use ; Arthritis, Rheumatoid ; drug therapy ; Drug Therapy, Combination ; Etanercept ; Female ; Glycosides ; therapeutic use ; Humans ; Immunoglobulin G ; therapeutic use ; Male ; Middle Aged ; Receptors, Tumor Necrosis Factor ; therapeutic use ; Treatment Outcome ; Tripterygium ; chemistry

Animals ; Cells, Cultured ; DNA ; analysis ; Flow Cytometry ; methods ; Fluorescence ; G1 Phase ; Resting Phase, Cell Cycle

Objective To discuss the correlation between cervical intraepithelial neoplasia(CIN) and uterine cervix cancer and the combination of TCT and colposcope for the investigation of cervical lesion.Methods 5545 patients were preliminarily screened by cervical fluid basement cell folium smear,in which 307 patients are masculine and 219 are negative,the 526 patients are suspected cervical lesions in clinical symptoms and they further underwent colposcopy and biopsy,the results were analyzed by pathohistology which is golden standard.Results CIN coherent dangerous factors analyzed by single factor Logistic regression analysis are:cervical HPV pollution,age of sexual activity,sexual partners numbers,protection of sexual life, STD history,age and frequency of miscarriage ( P < 0.05 ).The coincidence between TCT,colposeopy and pathologic diagnosis are 49.4%, 83.8% ;the omission diagnostic rate of LSIL,HSIL and CC from TCT are 63.63% ,74.44% ,100% ;the omission diagnostic rate of LSIL,HSIL and CC from colposcopy are 33.37%, 12.22% ,0;the sensitivity of TCT,colposcopy and TCT combine colposcopy for CIN are 61.2% ,84.6% ,94.5% and specificity are 85.4% ,88.2.% ,90.8%.Conclusions (1)The generation of CIN and cervical cancer are correlated with cervical HPV pollution,sexual behavior and various kinds of lower genital tract infection.(2) Fluid basement cell folium smear can promote the property of diagnosis,meet the demands of early stage uterus neck cancer and precancer lesion investigation,are suitable to be routine cheek methods in primary hospital.