0.05).Except imipenem and ampicillin,there was significant difference between the resistance of non-ESBLs-producing strains from CAP and from HAP to other eleven kinds of antibiotics(?2 test,P

OBJECTIVE Approach the cause of esophageal perforation and the analysis of diagnosis, therapy and its outcome in this disease. METHODS We retrospectively review 11 patients of esophageal perforation between1997 and 2004 in our department. There were 9 cases were taken out foreign bodies from their esophageal, another 2 cases haven't been found any foreignbodies and 1 of 2 was caused by iatrogenic reasons. Perforation occurred in the cervical esophagus was 4, and in the thoracic esophagus was 7. Their symptoms were dysphagia or pain, retrosternal-pain, dyspnea, subcutaneous emphysema, fever, hematemesis or melena. RESULTS 7/11 cases visited the clinic during 24 hours after foreign-body occured, 4/11 cases visited after 24 hours and the last visited clinic on 27th day late. Dysphagia was the most common presenting symptom specially with pain in eating, noted in 9 cases (81.8 %); retrosternal-pain and fever were noted in 8 cases (72.7 %), subcutaneous emphysema in 5 (45.5 %), dyspnea in 2 (18.2 %), hematemesis and melena.in 1 (9.1 %). 5 cases were died and the common mortality was 45.45 % (5/11). The mortality in primary repair with surgery treatment was 66.7 % (2/3); the mortality in conservative management was 37.5 % (3/8). The mortality of the perforation in cervical esophagus was 25 % (1/4), in thoracic esophagus was 57.14 % (4/7). The mortality of the visit time in 24 hours was 28.57 % (2/7),and out of 24 hour was 75% (3/4). CONCLUSION Sophageal perforation is usually caused by foreign body or iatrogenic in ENT-Head&Neck surgery. The esophageal perforation will been cured that decided in early visiting, taking away of foreign-boby, the right choice of antibiotic, nutritional support, primary healthy statement of esophagus. We regard that should perform non-operational conservative therapy in the patients who resulted in esophageal perforation except abscess or remain causing by foreign body. And the high risks in mortality of the repairing in surgery should been noticed.

Objective To investigate the evolution of nonspecific manifestations of pulmonary function in elderly people.Methods Retrospective analysis of the data of nonspecific pulmonary function(NSPF) on the initial PF testing in elderly people from the same PFT apparatus in Beijing Hospital were collected from January 2004 to December 2012.All the patients with complete clinical data and reexamination at least one time were enrolled into this analysis.NSPF was defined as normal FEV1/FVC and TLC combined with a decreased FEV1 or FVC or both.All the patients with complete clinical data were divided into blocking group,restricted group,NFSP group and normal group according to their PF.The comparison was performed among these groups.Kaplan-Meier was used for analysis of the turnover and outcome of elderly NSPF patients,log-rank test was used for comparing the difference of turnover and outcome and COX regression was used for analyzing single and multiple factors of different turnover and outcome.Results Overall 59 patients were diagnosed as NSPF,with male:female ratio of 52:7,the average age of(71.8 ± 8.8)years and at a median follow-up of 4 years.The statistically significant differences in age,sex,body mass index(BMI),smoking status,both the clinical manifestations and chest CT performance at first visit and during the following-up were not found among the groups(all P ＞0.05).The pulmonary functions of NSPF patients were transformed into an obstructive pattern(19.6 ％),into a restrictive pattern(7.6 ％)and into a normal pattern(8.8 ％) in 4 years cumulative incidence rate,with statistically significant in differences(x2 =7.411,P =0.024).An invariant pulmonary function in NSPF patients accounted for 64.0％ in the most,and the second was obstructive ventilation function disability.Monomial and multinomial Cox regression analysis showed that emphysema and bulla in the initial CT scan was the predictor of the change to the obstructive pattern from NSPF during follow-up(HR=4.325,P=0.045),age was the predictor of the change to the restrictive pattern(HR=1.143,P=0.020).And pleural thickening and disappearing of pleural effusion were the predictor of change to the normal pattern (HR =8.889,P =0.018) respectively.Conclusions Most NSPF in elderly people could exist consistently.Obstructive pattern is the maximal likelihood of NSPF changing to the other pattern.Emphysema and bulla in the initial CT scan is the predictor of the obstructive pattern.The change is related with emphysema and bulla in the initial CT scan.

Adult ; Diagnosis, Differential ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Phytotherapy ; Prostatitis ; drug therapy ; prevention & control

Acute Disease ; Asthma ; drug therapy ; Bronchodilator Agents ; administration & dosage ; adverse effects ; therapeutic use ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Infusions, Intravenous ; Male ; Theophylline ; administration & dosage ; adverse effects ; analogs & derivatives ; therapeutic use ; Treatment Outcome

ObjectiveTo investigate the value of ultrasound in diagnosis and differential diagnosis of uterine arteriovenous fistula (UAF).MethodsUltrasound results of 12 patients with UAF were analyzed retrospectively,and were compared with uterine artery angiography.ResultsUAF showed uneven echo signals of uterine muscle wall near endometrium or cesarean section incision and irregular echo-free zone on ultrasonographies,the typical case of which displayed “honeycomblike” change.Color Doppler ultrasound showed rich blood flow in local area and lake-like or multicolored mosaic change.Spectral Doppler waveform shape was characterized as high-speed low resistance.The ultrasonographic results of UAF were consistent with those of uterine artery angiography.ConclusionUltrasonography combined with uterine artery angiography contributes to the diagnosis of UAF.

Objective To observe the effects on rabbit corneas and retinas after single intravitreal injection of voriconazole at different doses.Methods According to the randomization table,25 healthy rabbits were randomly divided into control group,and voriconazole 50,100,200,and 400 μg groups.Therefore,there were 5 rabbits in each group.The eyes of control group received intravitreal injection of 0.1 ml balanced saline solution,and those treatment groups received 0.1 ml voriconazole injection of corresponding dose.Before the injection and 1,7,and 14 days after the injection,endothelial cell counts and corneal thicknesses were measured;full-field electroretinogram were performed and b-wave amplitudes in maximal combined reaction (Max-R) were recorded.On 14 days after the injection,histologic structures were observed by light microscope and transmission electron microscope.Results There was no significant difference in endothelial cell counts (F=0.320,0.291,0.467,0.649) and corneal thicknesses (F=0.214,0.284,0.360,0.225) with those of control group at any time points (P＞0.05).Before and 1 day after the injection,b-wave amplitudes of each voriconazole group had no significant difference compared with those of control group (F=0.220,0.106;P＞0.05).On 7 days after the injection,b-wave amplitudes decreased significantly at doses of 200 μg and 400 μg (P＜0.05).On 14 days after the injection,there was no significant difference between the the amplitude of 200 μg group and that of control group (P＞ 0.05).However,the amplitude of the 400 μg group decreased continuously and there was still significant difference (P＜0.05).Light microscopy did not reveal any corneal abnormality in both control group and voriconazole groups.The retinas were normal except that of the 400 μg group,which had a thinner and degenerated inner nuclear layer and disordered photoreceptor layer.Under transmission electron microscope,there were no ultrastructure damages of corneas in both control group and voriconazole groups,either.The rabbit retinas of the 50 μg and 200 μg group have normal inner nuclear layer and photoreceptor layer,but degrees of changes in both layers were observed in the eyes of 200 μg and 400 μg group.Conclusions There is no obvious effects on rabbit corneas and retinas after single intravitreal injection of voriconazole at he dose less than or equal 100 μg.There are no obvious effects on rabbit corneas at the dose of 200 μg and 400 μg,while there are damages to the retinas in both functions and histological structures.

Objective:To study the effect of Qingyi Lidan Granule on the serum levels of high mobility group box 1 (HMGB 1),heat shock protein 70 (HSP70),heat shock protein 27 (HSP27) and interleukin-8 (IL-8) of patients with severe acute pancreatitis.Methods:From August 2015 to July 2016,84 patients with severe acute pancreatitis in our hospital were selected and randomly divided into the observation group and the control group according to random number,42 cases in each group.The control group was given routine treatment,and the observation group was treated by Qingyi Lidan Granule on the basis of control group.The recovery of blood amylase to normal time,white blood cell recovery to normal time,recovery of gastrointestinal function to normal time and relieving time of abdominal pain,serum levels of HMGB1,HSP70,HSP72 and IL-8 in both groups were observed and compared before and after treatment.Results:After treatment,the total clinical effective rate of observation group was significantly higher than that of the control group[92.86％ (39/42) vs 71.43％ (30/42)] (P＜0.05).The recovery of blood amylase to normal time,white blood cell recovery to normal time,recovery of gastrointestinal function to normal time and relieving time of abdominal pain in the observation group were significantly shorter than those of the control group (P ＜0.05).Before treatment,no significant difference was found in the serum levels of HMGB 1,HSP70,HSP72,IL-8 between groups (P＞0.05).After treatment,the serum levels ofHMGB1,HSP70,HSP72 and IL-8 in both groups were significantly lower than those before treatment (P＜0.05).The levels ofHMGB1,HSP70,HSP72 and IL-8 in the observation group were lower than those in the control group (P＜0.05).Conclusion:Qingyi Lidan Granule could effectively reduce the levels of serum HMGB 1,H SP70,HSP27 and IL-8 and enhance the clinical curative effect of patients with severe acute pancreatitis.

Objective:To explore the relationship among childhood psychological maltreatment,online aggressivebehavior and trait anger in college students.Methods:Totally 442 college students (226males,216 females,aged 16-25 years) were surveyed with the Psychological Maltreatment Scale (PMS),Adolescent Online Aggressive Behavior Scale (AOABS) and Trait Anger Scale (TAS).The bias-corrected percentile bootstrap method was used to analyze the mediating effect of trait anger between childhood psychological maltreatment and online aggressive behavior.Results:The scores of PMS,AOABS and TAS were positively correlated each other(r =0.44,0.37,0.48,Ps ＜0.01).The PMS scores had a significantly direct effect on the AOABS scores,its estimate was 0.27.The PMS scoreshad a significantly indirect effect on the AOABS scores through TAS scores(95％ CI:0.15-0.34).Conclusion:It suggests that the trait anger may be related to childhood psychological maltreatment and online aggressive behavior,and trait anger may play a partial mediating role between childhood psychological maltreatment and online aggressive behaviorin college students.

Objective To develop the scale to measure online intimate relationship and test its validity and reliability for college students.Methods A total of 1 105 subjects were recruited in this investigation for 6 times.Based on literatures,open-ended questionnaire investigations,semi-structured interview and experts' opinions,item analyses,exploratory factor analyses,validity and reliability analysis were conducted to develop the scale.Results The self-made scale showed a second-order structure,including intimacy,passion and commitment dimension.Confirmatory factor analysis showed that the model had good fit (χ2/df=3.47,GFI=0.92,NFI=0.90,CFI=0.92,TLI=0.90,IFI=0.92,RMSEA=0.08).The 3 dimensions had good internal reliability with Cronbach's α coefficients from 0.73 to 0.89 and retest reliability coefficients from 0.80 to 0.91.In addition,the scale had good external validity and convergent validity.ConclusionThe self-made scale has acceptable reliabilities and validities,which can be used to measure online intimate relationship for college students.