Objective To evaluate the diagnostic and prognostic evaluation of Procalcitonin (PCT)levels detection for elderly patients with severe pulmonary infection.Methods 60 elderly patients with severe pulmonary infection were selected,as the infected group,wherein 45 cases with bacterial infection,15 cases with non -bacterial infections.Another 60 cases elderly patients excluded infectious diseases were selected as the control group.PCT,CRP and WBC levels in two groups were detected and compared.The infection group was randomly divided into two groups,each of 30 cases,the control group received conventional anti -infection treatment,while the observation group developed solutions to optimize antimicrobial drugs by detecting changes in PCT and CRP.Antibiotic course,antimi-crobial drug costs,superinfection and adverse reaction rates in two groups were recorded and compared.Results PCT,CRP levels and WBC in the infected group were (17.4 ±11.3)ng/mL,(43.5 ±18.7)mg/L and (10.4 ± 7.3)×109 /L,which in the control group were (0.4 ±0.2)ng/mL,(6.3 ±3.6)mg/L and (5.4 ±1.4)×109 /L,the difference was statistically significance (t =7.369,9.570,3.295,all P <0.05 ).PCT levels of bacterial infection group was (27.2 ±14.7)ng/mL,which in non -bacterial infection group was (8.2 ±2.7)ng/mL,the difference was statistically significant (t =7.369,9.570,3.295,all P <0.05).Antibiotic course,antimicrobial drug costs,superin-fection and adverse reactions in the observation group were significantly lower than those in the control group,the difference statistically significant (t =6.994,27.71,χ2 =6.171,6.984,all P <0.05).Conclusion PCT detection has an important value of infection diagnosis especially in elderly patients with severe pulmonary infection,and can be used as the basis for antibiotic treatment.

Objective To observe and compare the clinical efficacy,recurrence rate and safety of differ-ent courses of inhalation fluticasone propionate in treatment of children with cough variant asthma. Methods A total of 101 children with cough variant asthma in our hospital were randomly divided into three treatment groups,all with the same therapy drug -fluticasone propionate and with the treatment time of two months, six months and nine months respectively. Clinical efficacy and treatment compliance were followed up during the treatment. After discontinuation,observation for the relapse of cough was followed up for 6 months. In inhalation therapy before and after,bone mineral density( BMD) and blood cortisol,electrocardiogram were monitored re-spectively to observe its safety. Results Three groups of children with cough were all get effective control,with no significant difference(H=5. 2894,P=0. 0710). The two months treatment group(A group)was more easy to relapse than the six months treatment group( B group) and the nine months treatment group( C group) after drug withdrawal,statistically significant(χ2 =4. 858 1,P=0. 027 5;χ2 =4. 482 6,P=0. 034 2). But after drug with-drawal,there was no significant difference in the rate of relapse in B and C group(χ2 =0. 022 2,P=0. 881 4). There were few changes in laboratory values about morning serum cortosol concentrations. There was no signifi-cant decrease in BMD after treatment. No other adverse events were observed in this study. Conclusion Flutica-sone propionate inhalation treating children cough variant asthma has good effection. A long period of treatment scheme(6 months)has better curative effect and lower recurrence rate after drug withdrawal.

0.05),but there was difference between shikonin group and control one (P

Acute Disease ; Adolescent ; Adult ; Aniline Compounds ; poisoning ; Humans ; Male ; Middle Aged ; Occupational Diseases ; chemically induced ; diagnosis ; drug therapy ; Poisoning ; diagnosis ; drug therapy

Adult ; Antihypertensive Agents ; therapeutic use ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Hypertension, Portal ; drug therapy ; Liver Cirrhosis ; drug therapy ; Male ; Middle Aged ; Phytotherapy ; Propranolol ; therapeutic use ; Salvia miltiorrhiza ; chemistry

Objective To investigate the interference effect of calcium dobesilate on serum creatinine levels by Sarcosine oxidase-based assay.Methods 1.Interference test in vivo:Ten patients with chronic renal diseases from Huangshi second hosptial were recruited.Serum creatinine (sarcosine oxidase method,Scr1 ; deiminase method,Scr2),urea,and cystatin C were detected and compared before and after one week administration of calcium dobesilate; 2.Interference test in vitro:to detect whether 100 mg/L calcium dobesilate has any interference with Scr1 and Scr2; 3.Dose-dependent interference test:To detect the interference effect of different concentrations of calcium dobesilate (1.25-20.0 mg/L) on different creatinine concentrations (404.5 μmol/L or 65.9 μmoL/L) measured by sarcosine oxidase assay.Bias within 3.5％ or 6.63 μmol/L of creatinine levels was clinically acceptable.Statistical comparisons were made using Wilcoxon rank-sum test.Results There was significant difference of sarcosine oxidase-based serum creatinine levels between before and after one week administration of calcium dobesilate (P ＜ 0.05),while no significant differences were observed for deiminase-based serum creatinine levels,urea and estimated GFR values (P ＞ 0.05).Interference test showed that 95％ confidence interval of interventional value (Dobs) of calcium dobesilate (100 mg/L) was (-173.9 ± 2.86) μmol/L for the sarcosine oxidase assay and (1.21 ± 3.14) μmol/L for deiminase method,indicating that calcium dobesilate caused a significant negative effect on the former enzymatic assay but not the latter one.In the dose effect interference test of calcium dobesilate,the regression equations were:Y =-2.7649X-0.0782 (R2 =0.998,F =7943.4,P =0.000) for high creatinine levels and Y =0.0263X2-1.6394X-0.2754 (R2 =0.996,F =2546.7,P =0.000) for low creatinine levels.The interference effect was less than the predetermined d with the calcium dobesilate concentrations of 4.4 mg/L in high concentration specimen and 3.5 mg/L in low concentration specimen.Conclusions Calcium dobesilate has a significant negative interference with serum creatinine detected by the sarcosine oxidase method,which leads to the bias of creatinine in patients with renal insufficiency.Hence,sarcosine-oxidase-based creatinine levels should be cautious when calcium dobesilate was used,and further check with another assay is necessary if possible.

Objective To evaluate the outcomes of thoracoscopy-assisted mini-incision procedure in patients with lung cancer.Methods From January 2003 to June 2003,66 patients with non-small cell lung cancer were treated in our hospital by lobectomy combined with mediastinal lymph node resection using thoracoscopy-assisted mini-incision(36 patients,VATS Group)or traditional surgery(30 patients,traditional group).The clinical and follow-up data of the two groups were compared after the operation.Results No significant difference was found in the operation time between the VATS and traditional groups(114.6?47.4)min vs(123.3?43.9)min,t=-0.768,P=0.449],while the postoperative hospital stay of the VATS group was significantly shorter than that in the traditional group (9.2?1.4)d vs(10.5?1.7)d,t=-3.408,P=0.001].Log-rank test showed that the survival curve in the two groups was comparable(?2=0.270,P=0.605).Cox regression model indicated that the pathological characteristics(risk ratio:3.912,P=0.000),TNM stage(risk ratio:3.737,P=0.000),and lymph node metastasis(risk ratio:15.495,P=0.000)were independent,unfavorable prognostic factors for the disease;whereas,no relation was detected between the thoracotomy incision and prognosis(P=0.414).Conclusions Thoracoscopy-assisted mini-incision procedure is a safe and reliable approach for patients with lung cancer with satisfying outcomes.

OBJECTIVE:To analyze the effects of different disinfectants on results of antibiotics skin test,and to improve the accuracy of the judgment results of antibiotics skin test. METHODS:1 500 patients undergoing antibiotics skin test of penicillin and cephalosporin were randomly divided into group A and group B with 750 patients in each group. Group A was given 75% etha-nol disinfection,and group B was given iodine disinfection. The incidence of false positive results were compared after disinfected with 2 kinds of disinfectants. RESULTS:The incidence of false positive result in group B was lower than in group A,with statisti-cally significant difference (χ2=10.004,P<0.05). CONCLUSIONS:For skin disinfection of antibiotics skin test,iodine is better and safer than 75%ethanol.

Objective To explore the efficacy of endoscopic surgery for juvenile nasopharyngeal angiofibroma.MethodsDuring 27 years from March 1980 to July 2007,we performed endoscopic surgery on totally 19 patients with nasopharyngeal angiofibromas.According to Radkowski Stating,five of the patients were stage ⅠA,ten were stage ⅠB,and 4 were stage ⅡA.Before the endoscopy,superselective embolization was performed in all the cases via bilateral maxillary arteries.Results All tumors were successfully resected by endoscopy.The intraoperative blood loss was 200-600 ml.One of the stageⅡA patient developed cerebrospinal rhinorrhea during the endoscopic resection,and thus received repair of the middle turbinate by a mucosal patch immediately.In this series of patients,no massive epistaxis,intracerebral infection,or blindness occurred.Follow-up at three months after the surgery by nasoscopy showed epithelialisation of the nasal mucous membrane without residual tumor tissues.Meanwhile,otoscopy revealed normal light reflex of the eardrum,no fluid in the middle ear.Of the patients,eleven were followed up for one to five years,during which none of them had recurrent tumors confirmed by nasoscopy or CT scan.Conclusions Endoscopic resection of nasopharyngeal angiofibroma results in little trauma and few blood loss after superselective embolization.Experience and surgical skills are key points for the operation.

Objective To investigate the management status of loaner surgical instruments,and evaluate the effect of plan-do-check-act cycle (PDCA)quality control on loaner surgical instrument management.Methods From July 2011 to June 2012,8 965 pieces of loaner surgical instruments before adopting PDCA quality control management was as control group;from July 2012 to June 2013,8 564 pieces of loaner surgical instruments adopting PDCA quality control was as ob-servation group.The defects of loaner surgical instruments during application process and effect of PDCA quality control on loaner surgical instrument management were analyzed.Results There were many problems in checking-tracking,cleaning quality and company personnel of loaner surgical instruments.The qualified rate of observation group was higher than that of control group(99.36% vs 96.27%)(χ2 =194.74,P <0.01).The main causes for unqualification of observation group were unqualified cleaning (n=21 ,38.18%)and incomplete function of instruments(n=8,14.55%);while the main causes for unqualification of control group were the loss of instruments(n=81,24.25%),lack of monitor and record (n=71, 21.26%),unqualified cleaning(n=55,16.47%)and the soaking of package(n=54,16.17%).Conclusion PDCA quality control is an effective method for loaner surgical instruments management,it is helpful for building long-term effective quali-ty control system for loaner surgical instruments,and make loaner surgical instrument management more scientific,system-atic,and standard.