Objective To evaluate the efficacy and side effects of artemether combined with primaquine in the treatment of falciparum malaria. Methods Randomization and comparison methods were used in 121 falciparum malaria cases in the Republic of Central Africa.Sixty one cases were treated with artemether combined with primaquine(Group A used artemether orally,Group B used artemether intramuscularly).And 60 cases received single artemether (Group C used artemether orally,Group D used artemether intramuscularly ) were taken as control. Results In Group A and B the mean fever clearance time were 47 6?15 7 and 36 9?10 7 hours, clinical cure rates 84 4% and 100%, relapse rates 6 3% and 3 4% ,respectively.In Group C and D the mean fever clearance time were 48 2?18 4 and 42 2?9 5 hours,clinical cure rates 90 1% and 96 3%, relapse rates 21 2% and 18 5%,respectively.Side effects in cases of all groups were mild. Conclusion Artemether combined with primaquine and single artemether(via both routes) showed good therapeutic effects in falciparum malaria cases, while artemether combined with primaquine was more effective than single artemether in reducing relapes rate of malaria.

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Objective To explore the effects of health education based on mobile platform for patients after coronary stent implantation. Methods Totally 118 patients underwent coronary stent implantation were recruited using convenience sampling method,and divided into the experimental group and the control group by random number table method with 59 cases in each group. The control group received face-to-face health education during hospitalization from nurses,and were followed up at 1 month,3 months and 6 months through phone or outpatient follow-up. The experimental group received health education based on mobile platform. Self-designed questionnaire was used to investigate health behavior and self-efficacy at 1 month,3 months and 6 months for two groups. Results The scores of health questionnaire in the experimental group were better than those in the control group at 1 month,3 months and 6 months,and the difference was statistically significant (P<0.001);there was no difference in self-efficacy between two groups at 1 month(P>0.05),but at 3 months and 6 months the differences were significant (P<0.001). Conclusion Health education based on mobile health education platform for patients after coronary stent implantation can effectively improve health behavior and self-efficacy,and it is worthy of clinical popularization.

ObjectiveBoth kilovolt (KV) cone-beam computed tomography (CBCT) and KV radiography can determine set-up errors for patients with head-and-neck cancer.This study is to compare their performance.Methods16 patients with head and neck cancer were enrolled in this study.There were 160 sets of CBCT and corresponding orthogonal radiography images.Through registration of CBCT images with the planning CT images,and registration of radiography images with the digitally reconstructed radiographs,translational set-up errors were determined along left-right (x),super-inferior (y),and anterior-posterior (z) directions.Pearson correlation analysis was performed to evaluate the correlation of the set up errors determined by the two methods,and Bland-Altman plot analysis was used to assess the coincidence of these two methods.ResultsThe Pearson coefficient of correlation along all three directions was less than 0.01,and R2 was 0.95,0.84,0.81 on x,y,z,respectively.That means high correlation for two methods.The Bland-Altman plot analysis showed that the 95％ agreement limits of agreement were within preset 2 mm tolerance (x[ 1.3mm,- 1.2mm],y[ 1.6mm,- 1.1mm],z[0.8mm,-1.4 mm] ),which indicates an agreement exists for two methods.ConclusionsFor determination of set-up errors for patients with head and neck cancer,KV radiography is equivalent to CBCT.Considering CBCT delivers higher dose than KV radiography,but provides more soft tissue information.We suggest to use these two methods combinative in clinic.

OBJECTIVE To discuss the reasons of causing mistakes in the nosocomial infection reports.METHODS We collected 183 cases with inaccurate reports and analyzed them by the prospective method.RESULTS The major reasons of causing the inaccurate nosocomial infection reports were the ill-defined infection time,inaccurate diagnostic standard,and the lack of clinic training.CONCLUSIONS It can reduce the inaccurate nosocomial infection reports,advance the level of nosocomical infection diagnosis,and improve the work efficiency through special training,in paralleling with the manager of nosocomial infection going deep into sickroom and communicating with clinicians.

Objective To evaluate target-volume coverage and organ at risk (OAR) protection achieved with conventional radiotherapy (CRT), three dimensional eonformal radiotherapy (3DCRT) , and intensity-modulated radiotherapy(IMRT) through dosimetric comparison in patients with cervical cancer after hysterectomy. Methods The planning CT scans of 10 patients treated with pelvic radiation after hysterectomy for cervical cancer were used to generate CRT,3DCRT and IMRT plans for this study. Clinical target volume(CTV) was contoured on the individual axial CT slices of every patient. The CTV was then uniformly expanded by 1.0 cm to create the planning target volume (PTV). The small bowel, rectum, bladder, bone marrow, ovaries, and femoral heads were outlined for the organ at risk (OAR) evaluation. The CRT ,3DCRT and IMRT plans were generated using commercial planning software. CRT plan was prescribed to deliver 45 Gy to the reference point,while IMRT and 3DCRT plans were 45 Gy to 95% of the FFV. Isodose line and dose volume histograms(DVH) were used to evaluate the dose distribution in CTV and OAR. Results For 10 patients, the average volume of CTV receiving the prescribed dose of CRT was significantly lower than 3DCRT( Q = 8.27,P ＜ 0.01 ) and IMRT( Q = 8.37, P ＜ 0.01 ), respectively. Comparing with the CRT plan,the 3DCRT and IMRT plans notably reduced the volume of bowel at 30 and 45 Gy levels. The IMRT plan significantly spared rectum and bladder at 30 and 45 Gy levels comparing with the CRT ( P ＜ 0.01 ) and 3DCRT( P ＜ 0.05 ) plans,while the 3DCRT plan significantly spared rectum and bladder at 45 Gy level comparing with the CRT( P ＜0.01 ) plans. For 4 patients with ovarian transposition, the average doses of ovary over 3 Gy were 2 patients with the 3DCRT and IMRT plans, and 2 with all three plans. Conclusions IMRT and 3DCRT are superior to CRT in improving dose coverage of target volume and sparing of OAR ,while IMRT being the best. The superiority of IMRT and 3DCRT is obvious in sparing bone marrow at high dose levels. IMRT,3DCRT and CRT could not spare the transposed ovary effectively.

Objective To investigate the influence of esmolol infusion on QT dispersity(QTd)in elderly patients with coronary heart disease during perioperafive period.Methods Fifty ASA Ⅱ or Ⅲ patients with coronary heart disease aged 65-80 yr undegoing non-cardiac surgery under general anesthesia were randomly divided into 2 groups(n=25 each):control group(group C)and esmolol group(group E).Anesthesia was induced with midazolam,fentanyl and vecuronium and maintained with continuous iv infusion of propofol andvecuronium and intermittent iv boluses of fentanyl.The patients were intubated and mechanically ventilated.PETCO2 was maintained at 25-35 mm Hg.In group E a loading dose of esmolol 0.5 mg/kg was given iv over 1 min at 2 min before skin incision and was followed by esmolol infusion at 25 μg·kg-1·min-1 maintained until the end of operation.Radial artery was caunulated.MAP,HR,SpO2 and PETCO2 were continuously momtored.ECG composed of 12 leads was momtored before operation,at 30 min after skin incision,immediately after operation,and at postsurgery days 1 and 2.The longest and shortest QT intervals were measured and detected by a cardiologist not involved in the study.The QTd was calculated.The ventricular arrhythmia was also recorded.Results QTd,the incidences of QTd abnormality and ventricular arrbythmia were significantly lower in group E than in group C.Conclusion The use ofesmolol during operation may decrease QTd and prevent the occurrence ofventricular arrhythmia.

Objective To evaluate the effect of low-dose colonic CT scanning in image quality and lesion revealing with different noise idex.Methods Model group:in order to find the optimal scanning parameter range,small simulated polyps in pig colon was prepared and mA was modulated by regulating noise index.Images were reprocessed with CT colonography and Raysum reconstructions.Image quality and the lesion revealing situation were evaluated and scored based on both reconstructive and axial images.The study of patient group was prospective and continuous.All positive cases were comfirmed by biopsy or surgery pathology.Two groups of patients were enrolled.First group(39 cases from January 2007 to June 2007):patients were divided into three sub-groups randomly(15 cages with NI=10,13 cases with NI:13,11 cases with NI=16),while NI was not changed with position.Second group(32 cases from Jury 2007 to January 2008):patients were scanned and NI was changed with different position(NI=10,20).The average X-ray radiation values of two patient groups were compared with standard values.All data were processed with rank sum tesL Results First group:when NI=10,the average scores of axial and constructive images were 4.2 and 2.4 respectively,when NI=13,those were 3.2 and 2.5 respectively,When NI=16.those were 2.9 and 2.7 respectively.and the average CTDlw were 17.51,12.90 and 5.94 mGy respectively.When NI increased,the average scores of axial decreased(H=20.01,P＜0.01),the average scores of constructive images did not changed(H=0.81,P＞0.05).Second group:when NI=10,the average scores of axial and constructive images were respectively 3.6 and 2.3,when NI=20,those were 2.2 and 2.3 respectively,and the average CTDIw was 11.63 mGy.When NI increased from 10 to 20,the average scores of axial decreased(H=20.84,P＜0.01),the average scores of constructive images did not decreased(H=0.29,P＞0.05).In the first group,the average CTDIw wag reduced by 35.0%,52.1%and 77.9%respectively when NI was 10,13 and 16.In the second group,the average CTDIw Was reduced by 56.8%.Conclusions Auto-mA low-dose CT scanning could reduce X-ray radiation obviously,while not affecting image quality.

Objective To observe the changes of endothelin-1 (ET-1) and prostaglandin E2 (PGE2) in exhaled breath condensate (EBC) and serum of patients with acute respiratory distress syndrome (ARDS) after treated by Qingfeitang and investigate its clinical value. Methods 52 ARDS patients receiving mechanical ventilation at intensive care unit (ICU) were divided into the Qingfeitang treatment group and the control group, with 26 cases in each group. The EBC were collected by Ecoscreen condenser within 24 h after diagnosis of ARDS and on the 5th day of medication, and the venous blood were collected at the same time. The levels of ET-1 and PGE2 in the EBC and serum of different period were measured by EIA. Results (1) After treatment, The levels of ET-1 in EBC and serum of the Qingfeitang treatment group were significantly lower than those of the control group. (2) After treatment, the levels of PGE2 in serum of the Qingfeitang treatment group were significantly lower than that of the control group. (3) The oxygenation index difference before and after treatment of Qingfeitang in the treatment group was higher than in the control group. (4) The duration of mechanical ventilation of the Qingfeitang treatment group was significantly less than that of the control group. Conclusions Qingfeitang could be an effective method for alleviating acute respiratory distress syndrome.

Objective:To study the difference in anti-hepatic fiborsis components between pre-and post-processed Trionyx Sinensis Carapace to guide the clinical application of Trionyx Sinensis Carapace. Methods:SDS-PAGE gel electrophoresis was used to compare the constituents in pre-and post-processed Trionyx Sinensis Carapace, and the inhibitory effect on the proliferation of HSC-T6 was deter-mined by MTT. Results:The processed Trionyx Sinensis Carapace had much more components than the crude Trionyx Sinensis Cara-pace,and the relative molecular mass in the first-level band decreased resulting in the generation of micromolecular polypeptides. Both pre-and post-processed Trionyx Sinensis Carapace had anti-hepatic fibrosis, while the vinegar-processed Trionyx Sinensis was more ef-fective. Conclusion:The difference in the active components in pre- and post-processed Trionyx Sinensis Carapace is obvious, which provides foundation for the clinical application and further researches.