0.05).Conclusion Levofloxacin treating community-acquired pneumonia than gatifloxacin have more medicine economics advantage and it is in the prior choice.

AIM:To observe the image features of Vogt-Koyanagi-Harada disease (VKH) and multiple central serous chorioretinopathy (CSC) by fundus fluorescein angiography (FFA) and optical coherence tomography (OCT).METHODS:Thirty-two eyes of 17 patients with VKH and thirty-five eyes of 30 patients with multiple CSC were collected from 2009 to 2016 in my hospital.RESULTS:All the eyes with VKH were found small and dense fluorescein leakage in the early stage.The 17 eyes (53%) with VKH were found fluorescein accumulation in the final stage;24 eyes (75%) with VKH were found high fluorescence of optic disc.All of eyes with multiple CSC were found multifocal leakage in the early stage.And 2 eyes (6%) with multiple CSC were found high fluorescence of optic disc.There were 28 eyes (14 patients) with VKH and 25 eyes (22 patients) with multiple CSC had been done OCT in my hospital.Retinal pigment epithelial fold was only found in VKH.Fluctuation of internal limiting membrane (ILM) and membrane structure had higher sensitivity to diagnostic VKH from to multiple CSC, with sensitivity of 54% and 68% respectively.CONCLUSION:There are some similarities as well as differences between FFA and OCT in diagnosis of VKH and multiple CSC.A combination usage of FFA and OCT can be more effective in distinguishing VKH from multiple CSC.

Objective To explore the factors affecting blood level of elderly hypertensive patients, using a multilevel analysis model. Methods 927 elderly hypertensive patients from 23 communities were studied, through a multi-stage random sampling method. The influencing factors on systolic blood pressure (SBP) and diastolic blood pressure (DBP) were analyzed through a two-level linear multilevel model, respectively. Results The average blood pressure of subjects appeared as: SBP (139.2±11.7) mm Hg ( 1 mm Hg=0.133 kPa), DBP (85.6±8.6) mm Hg. Ratio of physician versus patients was the factor affecting blood level of subjects from the community level. SBP and DBP of the subjects from the higher physician/patient ratio communities were 3.86 mm Hg and 2.51 mm Hg, lower than the subjects in the lower ratio communities, after controlling the other related factors. Age, gender,overweight/obesity were the individual risk factors of hypertension, while factors as regularl medicine taking, reducing salt intake and related self-efficacy to manage disease could reduce the blood pressure.Reducing salt intake could lower the SBP for 2.44 mm Hg and DBP for 2.03 mm Hg, after controlling the other factors. Conclusion Multilevel analysis model could effectively analyze the hierarchically structured data while both factors from the community and individual levels could affect the blood level among elderly patients with hypertension.

Objective To analyze the characteristics of tuberculosis (TB) in renal-transplant recipients from our hospital, and summarize the corresponding experiences in diagnosis and management.Methods A retrospective study was performed on 61 documented post-transplant TB cases out of the 2842 patients who received kidney transplantation in the First Affiliated Hospital of Sun Yat-sen University between Jan.1991 and Dec.2010.Results TB in the post-renal-transplant population in our hospital displayed the following characteristics:(1) High incidence (2.1％ ).54.1％ recipients were diagnosed within the first year post-transplant; (2) Lung was the most common site (77.0 ％).There was high prevalence (60.7 ％) of extra-pulmonary TB (lymphatic TB,23.0 ％; pleuritis,13.1 ％; graft,11.5％); (3) Fever (83.6 ％),cough (55.7 ％),sputum (41.0 ％) were the most common clinical manifestations.There were also emaciation (3.3 ％) and enlargement of lymph nodes (18.0 ％); (4) Chest X-ray and CT were of great value during TB diagnosis while purified protein derivative of tuberculin (PPD) skin test had little diagnostic value with a negative result in 56 cases (91.8 ％) ; (5) Liver function damage ( 16.4 ％),kidney function injury (39.3 ％) and peripheral nerve toxicity (3.3 ％) were the main adverse reactions of anti-tuberculosis chemotherapy,also the major cause of anti-TB failure; (6) Pre-transplant TB (17 cases) increased the probability of TB recurrence (4 cases,23.5 ％) post-transplantation; (7) The post-transplant TB patients were accompanied with cellular immune deficiency,resulting in overlapping infection of bacteria,viruses and fungi (19.7 ％); (8) 1- and 3-year patient/graft survival rate of patients with post-transplant TB was 85.2 ％/78.7 ％ and 85.2 ％/75.4 ％ respectively. The accumulative mortality rate reached to 14.8％,while overlapping infection was the major cause of death (66.7 ％).Conclusion Chinese renal transplant recipients still face a high risk of TB because of their immunecompromised state and epidemiological prevalence of the disease. For the high mortality rate and associated serious complications,rapid diagnosis and effective anti-TB chemotherapy are of great value for TB population.

OBJECTIVETo observe improved effects of Jingjin acupuncture on fine activity of hemiplegic hand in recovery period of stroke.

METHODSFifty cases were randomly divided into an observation group and a control group, 25 cases in each one. Regular western medicine treatment, rehabilitation training and regular acupuncture (in which Shuigou (GV 26), Baihui (GV 20), Neiguan (PC 6), etc. were selected) were applied in both groups. Additionally, muscles in palm side of affected hand, dorsal metacarpophalangeal joints and proximal interphalangeal joints were treated with acupuncture in the observation group, once every other day and electroacupuncture was applied when arrival of qi was acquired. Baxie (EX-UE 9) in the affected hand were needled in the control group, and electroacupuncture was added when arrival of qi was acquired. Ten days of treatment was considered a treatment course, and after two courses Lindmark score, Brunnstrom movement function grade, joint range of hand and Barthel index (BI) were observed in two groups.

RESULTSCompared before the treatment, the Lindmark score in two groups were both improved after the treatment (both P < 0.01). Compared with the control group, the motor coordination ability, sensory function and total score of Lindmark in observation group were obviously improved (differences before and after treatment: 8.24 +/- 3.07 vs 6.84 +/- 2.43, 3.52 +/- 2.33 vs 2.16 +/- 2.12, 11.76 +/- 3.55 vs 9.00 +/- 3.62, all P < 0.05). The Brunnstrom movement function grade was significantly improved in both groups after treatment (both P < 0.01), which was more obvious in the observation group (P < 0.05). The joint range of hemiplegic hand was improved in both groups after treatment (both P < 0.01), which was more obvious in the observation group [differences before and after treatment: (25.35 +/- 10.91) degrees vs (18.65 +/- 7.86) degrees, p < 0.05]. The score of BI was also significantly improved after treatment in two groups (both P < 0.01).

CONCLUSIONThe Jingjin acupuncture could effectively improve fine activity of hemiplegic hand in recovery period of stroke prove daily life ability.

Acupuncture Therapy ; Aged ; Female ; Hand ; physiopathology ; Hemiplegia ; etiology ; physiopathology ; therapy ; Humans ; Male ; Middle Aged ; Movement ; Recovery of Function ; Stroke ; complications ; physiopathology

Liver fibrosis is a common pathological process for chronic liver injury caused by multiple etiological factors and an inevitable phase leading to liver cirrhosis. According to the previous studies, hesperidin (HDN) shows a very good protective effect on CCl4-induced chemical hepatic fibrosis in rats. In this experiment, based on the findings of the previous studies, a platelet-derived growth factor (PDGF)-induced HSC-T6 model was established to observe the inhibitory effect of HDN on HSC-T6 proliferation. The ELISA method was adopted to detect the content of collagen I in HSC-T6 supernatant. Transforming growth factor (TGF)-beta1, Smad2, Smad3, Smad7 and connective tissue growth factor (CTGF) mRNA expressions were measured by RT-PCR; TGF-beta1 and CT-GF protein expressions in HSC-T6 were determined by Western blot, in order to study HDN's effect on TGF-beta1 signaling pathway in HSC and its potential action mechanism. The results demonstrated that HDN could notably improve HSC-T6 proliferation, Collagen I growth and TGF-beta1, Smad2, Smad3 and CTGF mRNA.expressions. After being intervened with HDN, it could notably inhibit HSC-T6 proliferation and Collagen I growth, reduce TGF-beta1, Smad2, Smad3 and CTGF mRNA and TGF-beta1, CTGF protein expressions and increase Smad7 mRNA expression. HDN's antihepatic fibrosis effect may be related to the inhibition of HSC proliferation and activation by modulating TGF-beta/Smad signaling pathway.
Animals ; Cell Proliferation ; drug effects ; Cells, Cultured ; Connective Tissue Growth Factor ; physiology ; Hesperidin ; pharmacology ; Platelet-Derived Growth Factor ; pharmacology ; Rats ; Signal Transduction ; drug effects ; Smad Proteins ; physiology ; Transforming Growth Factor beta1 ; physiology

Objective To compare the therapeutic effect of angiotensin Ⅱ antagonist (Valsartan)and angiotension-converting enzyme inhibitor (Captopril) for the improvement of left ventricular systolic function(LVSF) after acute myocardial infarction (AMI) at anterior wall. Methods A total of 75 patients with initial AMI at anterior wall were enlisted in the study. Patients were divided randomly into three groups: control group (n = 15), Captopril treated (n =30), and Valsartan treated (n =30). At 1 week and 28 weeks post AMI, the LVSF and left ventricular regional ejection fraction (LrEF) were measured by equilibrium radionuclide angiography (ERNA). The t-test was used to compare the dada. Results ( 1 ) At 28 weeks, left ventricular ejection fraction (LVEF) and left ventricular peak ejection rate (LPER) in Valsartan treated group were significantly increased as compared with those of control: ( 59.4 ± 8.6 ) % vs (44.9 ± 8.4)%, t = 3.87, P ＜ 0.01 for LVEF; (3.89 ± 1.01 ) end-diastolic volume (EDV)/s vs (2.84 ±1.05) EDV/s, t= 4.16, P ＜ 0.01 for LPER). The left ventricular time to peak ejection rate (LTPER) in Valsartan treated group was significantly decreased ( ( 116 ± 16 )ms vs ( 137 ±20) ms, t =2.16, P ＜ 0.05 ) as compared with control. (2)Compared with 1-week, 28-week Valsartan treated group had a significant increase inLrEF2, LrEF4, LrEF5, LrEF6: (71.6±18.8)% vs (57.0±11.4)%, t=2.11, P＜0.05;(78.1 ±16.8)% vs (68.9±21.0)%, t =2.06, P＜0.05; (70.5±16.9)% vs (59.9 ±23.4)%, t=1.99, P ＜ 0.05; and (58.1 ± 9.0) % vs (46.0 ± 18.9) %, t = 2.43, P ＜ 0.05, respectively. Conclusions Valsartan and Captopril are effective for the improvement of LVEF after AMI at anterior wall. The effects of the two drugs are similar.

Objective To evaluate the effect of Diver CE aspiration thrombus catheter used in patients during the recovery of acute myocardial infarction (AMI) with percutaneous coronary intervention (PCI). Methods A total of 50 AMI patients were enrolled from January 2010 to December 2011. Twenty-ifve patients received PCI and used the Diver CE aspiration thrombus catheter (aspiration group);and the other 25 patients received routine PCI (routine PCI group). The basic characteristics, PCI characteristics, myocardial perfusion indexes and clinical data were compared and analyzed. Results There was no statistically difference between two groups in basic characteristics. Compared with the routine PCI group, higher rate of myocardial blush grade 3 but lower thrombus scores were found in the aspiration group. The incidence of no-lfow or slow-lfow were also lower in aspiration group (all P<0.05). The LVEF after 6 and 12 months were higher in the aspiration group (both P<0.05), no difference in MACE between the two groups. Conclusions Using the Diver CE thrombus aspiration in PCI is a simple and safe by method for treatment of acute myocardial infarction with high thrombosis burden. It can improve reperfusion decrease the rates of no-relfow on slow-relfow and can improve the long-term left ventricular function.

Objective: To evaluate the impact of intracoronary administration of eptifibatide oncoronary no-reflow and myocardium perfusion in patients with ST-elevation myocardial infarction (STEMI) at percutaneous coronary intervention (PCI). Methods: A total of 80 STEMI patients with emergent PCI were randomly divided into 2 groups: Eptifibatide group, the patients received intracoronary administration of eptiifbatide and Control group, the patients received the same volume of normal saline.n=40 in each group. The baseline condition, post-operative vascular recanalization, changes of platelet aggression at pre- and post-medication were compared between 2 groups. Echocardiography was examined at immediately and 24 weeks after operation;myocardial infusion imaging was examined at l week after operation. All patients were followed-up for 24 weeks to observe the incidence of major adverse cardiovascular events (MACE). Results: Compared with Control group, Eptifibatide group showed increased ratios of post-operative TIMI grade 3 (72.5%vs 92.5%) and myocardium perfusion (70.0% vs 90.0%), bothP<0.05; decreased post-operative and 2h post-medicinal platelet aggression and they were both lower than Control group at the same period, allP<0.05. Eptiifbatide group had obviously improved LVEDD and LVEF at 24-week than 1-week after PCI and they were both superior to Control group, allP<0.05. There were 7 (17.5%) patients in Eptiifbatide group and 7 (7.5%) in Control group suffering from small bleeding events, P>0.05; no severe bleeding eventand no in-hospital thrombocytopeniaoccurred. MACE occurrence rates during 24-week follow-up period were 12.5% vs 22.5%, P>0.05. Conclusion: Intracoronary administration of eptiifbatide in STEMI patients at emergent PCI could effectively improve coronary blood lfow,increase myocardium perfusion and enhance cardiac function without severe bleeding events.