Objective To study the clinical characteristics of severe pneumonia in children , to explore the significance of neutrophil elastase detection. Methods Patients were divided to severe pneumonia group and non-severe pneumonia group Fever, cough, lung wet rale duration and image changes were statistically analyzed. The percentage of abnormal lymphocyte in peripheral blood was counted by Wright's dyeing method. The neutrophil elastase expression in peripheral blood was determinated by enzyme-linked immunosorbent analysis. Results In severe pneumonia group,atelectasis occurred in 5 cases,8 cases complicated with heart failure, 8 cases complicated with respiratory failure and 4 cases were complicated with toxic encephalopathy. In severe pneumonia group , fever time was 13.5±5.1 days, cough time was 15.1±3.2 days, the time of lung wet rale duration was 12.2±2.3 days, which were significantly longer than that of non-severe pneumonia group (t = 2.346,2.457,2.346,P < 0.05);In severe pneumonia group , pathogens included streptococcus pneumoniae , respiratory syncytial virus and adenovirus , etc.In severe pneumonia group,the percentage of abnormal lymphocyte in peripheral blood smear increased with virus infection (8.1±1.2)%. In 12 cases of severe pneumonia,the expressions of neutrophil elastase were 127.6± 12.5 ng/ml, more than that of non-severe pneumonia group (75.4 ± 6.4 ng/ml,t=3.047, P<0.05). Conclusion Severe pneumonia is a serious diseases impacting children health. Detection of neutrophil elastase shows a markedly clinical value to judge the severity of pneumonia.

Objective To explore the relationship between KISS-1 gene and metastasis of bladder carcinoma,and to study the effect of the stable expression of KISS-1 gene on the invasion of bladder carcinoma cell line T24.Methods Fluorescent quantitative PCR was used to detect the expression of KISS-1 mRNA in primary bladder carcinoma without metastasis and primary bladder carcinoma with metastasis.Recombinant vector pIRES2-AKS-1 was constructed and transfected into T24 cells.Single clone of stably transfected cells was screened,and the changes in the invasive ability of T24 cells was detected after transfection.Results The expression level of KISS-1 mRNA in primary bladder carcinoma with metastasis was significantly lower than that in primary bladder carcinoma without metastasis(P＜0.05).The expression of KISS-1 protein in the single clone of stably transfected cells increased significantly,and the invasive ability significantly decreased(P＜0.05).Conclusion KISS-1 gene is correlated with the metastasis of bladder carcinoma,and the up-regulated expression of KISS-1 gene can inhibite the invasiveness of T24 cell line.

Objective To discuss the application of minimally invasive surgery in the treatment of esophageal leiomyoma. Methods Clinical data of 26 patients with esophageal leiomyoma from September 1996 to October 2002 treated by minimally invasive surgery were reviewed retrospectively. Results Video-assisted thoracoscopic leiomyoma enucleations were performed in 23 patients, and a conversion to mini-thoracotomy was required in 3 of them because of dense pleural adhesion (2 patients) or location failure of tumor (1 patient). The remaining 3 patients underwent transjugular leiomyoma enucleation (2 patients) or esophagoscopic resection of leiomyoma (1 patient), respectively. All the procedures were completed smoothly and the postoperative recovery was uneventful, without mortality or severe complications. All the patients were pathologically diagnosed as leiomyoma after surgery. Follow-up for 2 ～ 73 months (mean,32.3months) found no recurrence. Conclusions Video-assisted thoracoscopic enucleation can be the first choice for the esophageal leiomyomas that derived from lamina propria, while esophagoscopic removal may be considered for those from muscularis mucosa.

Objective To investigate the changes of the serum level of highly sensitive C-reactive protein (hs-CRP)in patients with cerebrovascular disease and its clinical significance. Methods The serum level of hs-CRP in 60 patients with acute cerebral infarction and 60 patients with acute cerebral hemorrhage and 40 healthy persons were determined.All the patients were scored by clinic neurological deficit scale(NDS),and were compared in groups. Results The serum level of hs-CRP in patients with acute cerebral infarction and with acute cerebral hemorrhage were significantly higher than that in normal controls(t=19.712 13.217 P <0.01).There was no obvious difference between the patients with acute cerebral infarction and with acute cerebral hemorrhage. Conclusion The serum level of hs-CRP was closely correlated with the severity of cerebrovascular disease.

Humans ; Respiratory Tract Infections ; complications ; microbiology ; Silicotuberculosis ; complications ; microbiology ; Tuberculosis, Multidrug-Resistant ; complications ; microbiology

Objective:To study the direct medical expenses for inpatients with Multiple Myeloma and explore its influencing factors. Methods:A total of 1386 hospitalization records were collected using the reimbursement claim database in Guangzhou City during the period from January 2009 to December 2011 , which covered the entire enroll-ees of Urban Employee Basic Medical Insurance ( UEBMI) and Urban Resident Basic Medical Insurance ( URBMI) . Multivariate logarithmic regression models were used to analyze the influencing factors of direct hospitalization costs. Results:During the period from 2009 to 2011 , the total costs of inpatients with Multiple Myeloma were 19319 . 16 , 17364. 76 and 21427. 44 Yuan, and the individual out-of-pocket cash payments were 7049. 37, 5216. 5 and 6475. 39 Yuan respectively. The major influencing factors on direct medical costs of inpatients with the aforesaid disease were identified to be age, health insurance type, hospital level and length of hospitalization. Besides, the proportion of drug expenses as per average occupancy rate among UEBMI and URBMI cases during three years were 61. 92% and 69. 22% respectively. Conclusion: The direct medical costs for inpatients with Multiple Myeloma are high and the medicine cost is the main component of total medical expenses. In addition, the economic burden is higher for patients with URBMI than for those with UEBMI for treating Multiple Myeloma.

Objective To evaluate the clinical value of 18F-FDG PET/CT in preoperative assessment for endometrial cancer.Methods A retrospective study was performed in 51 patients (average age (59± 12) years) with confirmed or suspicious diagnosis of endometrial cancer from February 2013 to December 2015.Thirty-three patients underwent curettage surgery at least 1 week before PET/CT imaging.With SUVmax as the statistical variable,comparison was made between the pathologically confirmed benign and malignant groups,and in case of the latter,the extent of infiltration,histologic grade and subtype of primary tumor,lymph node and distant metastases were also analyzed.Two-sample t test was used to analyze the data,and diagnostic efficacy of PET/CT for metastasis was calculated.Results There were 43 patients with endometrial cancer and 8 patients with benign uterine tumor.SUVmax was found to significantly correlate with histopathology classification (benign:3.4 ± 1.2,malignant:12.8 ± 6.5) and depth of myometrial invasion (≥1/2:17.7±5.4,＜1/2:10.9±5.9;t=-8.7 and 3.2,both P＜0.05),but not with cervical stromal invasion,histologic grade or histologic subtype(t =1.8,-1.9,1.5,all P＞0.05).The sensitivity,specificity,accuracy,positive predictive value (PPV) and negative predictive value (NPV) of PET/CT for the detection of lymph node metastases on a lesion basis were 85.7％ (18/21),98.2％ (271/276),97.3％ (289/ 297),78.3％(18/23),98.9％ (271/274),respectively,and on a patient basis were 6/6,97.3％ (36/ 37),97.7％ (42/43),6/7,100％ (36/36),respectively.The sensitivity and PPV of PET/CT for the detection of other metastases on a lesion basis were both 11/12.Conclusion SUVmax could be a clinically valuable tool for preoperative evaluation of the presence of deep myometrial invasion,lymph node metastases and other metastases in patients with endometrial cancer,particularly in specificity and NPV.

One hundred and twenty four patients with type 2 diabetes mellitus (T2DM) admitted to the Department of Endocrinology of Chuzhou First People's Hospital from April to October 2019 whose blood glucose levels were not controlled after treatment with metformin (2.0 g/d) for more than 3 months were enrolled in the study. The patients were randomly divided into oral drug group and liraglutide group with 62 cases in each group. On the basis of metformin, the oral drug group was treated with acarbose (300 mg/d); the liraglutide group was treated with liraglutide (1.2 mg/d). The course of treatment was 3 months. The body weight, fasting blood glucose (FPG), 2-h postprandial blood glucose (2 hPG), glycosylated hemoglobin (HbA1c), cholesterol (TC) and triglyceride (TG) levels were compared between the two groups before and after treatment, and the gastrointestinal symptoms and the incidence of hypoglycemia were analyzed. After 3-month treatment the body weight, FPG, 2 hPG, HbA1c of the two groups were lower than the baseline levels ( P<0.05). Compared with the oral group, the body weight, FPG, 2 hPG, HbA1c and TG in liraglutide group were more markedly decreased ( P<0.05). The gastrointestinal reaction of liraglutide group was significantly higher than that of the oral drug group, and there was no hypoglycemia in both groups. The data indicate that liraglutide combined with metformin can significantly improve the blood glucose, blood lipid and body weight of T2DM patients and no hypoglycemia occurs during the treatment.

10.3969/j.issn.1000-8179.2013.12.005

Objective To summarize the 18F-FDG PET/CT findings of LCH in children,and explore its value in the diagnosis of LCH.Methods PET/CT imaging and clinical data of 13 patients (6 males,7 females;average age (3.0±2.3) years) with LCH confirmed by histology before treatment from August 2011 to December 2015 in Xin Hua Hospital were retrospectively analyzed.Results All 13 patients have different degrees of bone destruction with increased metabolism,the common lesion sites were craniofacial bone,spine,limb long bones,ribs/chest/shoulder blade and pelvic bone.Lymph node lesions which manifested lymph node enlargement with increased metabolism were found in 10 cases,and the SUVmax was 4.0±1.3.Diffuse FDG uptake in spleen was found in 10 cases.There were 4 cases with liver lesions,3 with lung lesions,1 with high metabolic nodules in muscle,1 with orbital lesions and 1 with intraspinal high metabolic nodules.Conclusion 18F-FDG PET/CT could display the distribution and activity of LCH,and plays an important role in the diagnosis and systemic evaluation of LCH.