Objective To investigate the characteristics of pulmonary infection and susceptible factors following orthotopic liver transplantation (OLT). Methods Clinical data of 128 patients who underwent OLT from Feb. 1999 to Dec. 2004 were studied retrospectively in order to analyze primary pathogens, infectious time and susceptible factors.Results Forty-eight ( 37.5 %) of 128 patients had pulmonary infections and 27 ( 56.3 %) of them developed within postoperative 7 days. Thirty-four ( 70.8 %) cases suffered from mixed infection and 6 ( 12.5 %) died in the hospital after OLT. The primary pathogenic germs included Pseudomonas aeruginosa, Acinetobacter baumannii/haenolyticus, Golden staphylococcus, Aspergilosis and so on.Conclusion Pulmonary infection can be caused by various pathogens and associated with patients' constitution, mechanical ventilation, immunosuppressive drugs and so on.

Background There still is no a uniform diagnostic criteria for increasing population of dry eye.Studies showed that high tear osmotic pressure is one of causes of a variety of ocular surface discomfort,and the change of tear osmolality has been included in the definition of dry eye syndrome by Dry Eye World Study Group (DEWS) in 2007.It is very clinically significant to study the relationship of tear osmolality with dry eye.Objective This clinical trial was to study the correlation between tear osmolarity and dry eye severity based on Preferred Practice Pattern(PPP)of DEWS.Methods A descriptive study was performed.Fifty-four eyes of 54 patients with dry eye disease were asked to complete an evaluation of dry eye signs and symptoms questionnaire based on PPP.The ocular anterior segment was examined under the slit lamp biomicroscope.Cornealfluorescein staining,tear-film breakup time (BUT),Schirmer test Ⅰ (S Ⅰ t)without anesthesia were performed,and tear sample was collected for tear imageology and tear osmolarity admeasurement.The correlation between dry eye score with tear osmolarity was evaluated using Pearson linear correlation analysis.Written informed consent as obtained prior to any relevant medical procedure.Results The ratio of male and female patients was 1: 2 in this study.The negative correlations were found between tear osmolarity with S Ⅰ t or BUT(r =-0.456,-0.699,P＜0.01),and significantly positive correlations were found between tear osmolarity with tear imaging examination,corneal fluorescein staining,conjunctival hyperemia or dry eye symptom score(r=0.545,0.686,0.691,0.803,P＜0.01).Conclusions As a diagnostic method,tear osmolarity can objectively reflects dry eye severity.It can be a biomarker in dry eye severity grade when combined with clinical symptom.

Objective To investigate the application value of liquid-based thinprep cytologic test ( TCT) in diagnosis of cervical cancer and precancerous lesion. Methods The results of liquid-based thinprep cytologic test and TBS cytology subdivision from 9 012 patients were retrospectively analyzed, including 12 cases of ASC-US, 10 cases of ASC-H, 35 cases of LSIL, 72 cases of HSIL, 2 cases of SCC, and 6 ca-ses of gland cell abnormal. The abnormal results and the results of biopsy pathological diagnosis underwent colposcopy were compared. Results The liquid-based thinprepcytologic test showed that there were 285 cases of atypical squamous cells of undetermined significance (ASC-US), the positive rate was 3. 2%. The accordance rate of liquid-based thinprep cytologic test and colposcope histopathological diagnosis was 91. 24%. Conclusion TCT and TBS system can accurately reflect cervical intraepithelial lesion. Early detection and treatment of precancer-ous lesions is the key point of preventing cervical cancer.

OBJECTIVE:To optimize the forming technology for Zuojin dropping pill.METHODS:The base material and cooling agent were optimized by orthogonal experiment with the type of base material,the ratio of drug to base material,the temperature of physic liquor,the type of the cooling agent as factors taking the mixing state,forming condition and dissolution time as indexes; the dripping condition was optimized with the temperature of the cooling agent,the caliber of the dripping mouth,the dripping distance and dripping speed as factors taking the variation coefficient of the pill weight difference as index. RESULTS:The optimal forming technology was as follows:with polyglycol 4000 as base and paraffin oil as cooling agent; the cooling temperature was 12 ℃;the caliber of the dripping mouth was 3.5/4.9 mm;the dripping distance was 10 cm and the dripping speed was 25 drop?min-1.CONCLUSION:The forming technology is stable,reproducible and the preparation was well-shaped,and the forming technology serves as a reference for the production of Zuojin dropping pill.

Xueshuan Xinmaining tablet is a Chinese patent medicine for treating chest pain caused by blood stasis. It is widely used in clinical prevention and treatment of coronary heart disease. In order to understand the treatment effect of Xueshuan Xinmaining tablet in patients with coronary heart disease, we extracted electronic medical record data from 18 large hospitals nationwide. We matched the coronary artery disease patients with or without Xueshuan Xinmaining tablet treatment on gender, age, condition at admission and whether combined with cardiac insufficiency on a one to one ratio. After matching, both groups, patients using Xueshuan Xinmaining tablet (group A) and patients not using Xueshuan Xinmaining tablet (group B), ended up with 1,122 people. In order to evaluate the effectiveness of treatment, the endpoint of effective group was defined as "cure" and "better" while the endpoint of invalid group was defined as "invalid" and "death". Chi-square test showed a statistical significant difference (P < 0.05) between the two groups of patients with coronary heart disease, with a higher efficiency in Xueshuan Xinmaining group. Classic logistic regression analysis showed no statistical significant difference between the two groups on treatment outcome efficiency. Generalized boosted models (GBM) and propensity score (PS) weighted Logistic regression were then applied to balance 45 variables between the two groups. The results showed a regression coefficient greater than 0 and a statistical significant difference (P < 0.05) between the two groups. Based on the existing results of the analysis, we considered that coronary heart disease patients using Xueshuan Xinmaining tablet had a higher efficiency in clinical efficiency than the patients not using Xueshuan Xinmaining tablet. Since this study did not certainly eliminate all the possible confounders and patients from the hospitals included in this study were not yet well represent the overall situation of the source population, the study conclusion only provided drug use reference for clinical doctors for coronary heart disease. Large randomized controlled trials needs to be done for more reliable results to guide clinical rational and effective medication.
Adolescent ; Adult ; Aged ; Coronary Artery Disease ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Propensity Score ; Tablets

Objective To investigate whether mixed venous-arterial carbon dioxide difference (Pv-aCO2) combined with passive leg raising (PLR) could better guide volume management for patients post off-pump coronary artery bypass grafting (OPCABG).Methods Eighty patients experienced OPCABG, and admitted to Tianjin Chest Hospital from June 1st to October 1st in 2016 were enrolled. They were randomly divided into two groups: observation group given Pv-aCO2 combined with PLR directed therapy and control group given central venous pressure (CVP) directed therapy, 40 cases in each group. The difference in body temperature (T), heart rate (HR), mean arterial pressure (MAP), CVP, oxygenation index (PaO2/FiO2), mixed venous oxygen saturation (SvO2), Pv-aCO2, blood lactate (Lac), fluid intake, scores of the vasoactive agents at 6 hours post-operation, sequential organ failure assessment (SOFA) of 24 hours, mechanical ventilation time, the length of intensive care unit (ICU) stay, and hospitalization time were compared. The correlation between Pv-aCO2 and cardiac index (CI), Pv-aCO2 and Lac were analyzed by Spearman analysis in observation group.Results The T, HR, MAP, CVP, PaO2/FiO2, SvO2 and Lac at 6 hours post-operation were higher than those at admission in two groups, and Pv-aCO2 were significantly decreased. The SvO2 and fluid intake in observation group were higher than those in control group [SvO2: 0.671±0.068 vs. 0.634±0.052, fluid intake (mL): 454±151 vs. 304±106, bothP < 0.05], Pv-aCO2, Lac and scores of the vasoactive agents were lower than those in control group [Pv-aCO2 (mmHg, 1 mmHg = 0.133 kPa): 6.1±1.8 vs. 7.0±1.8, Lac (mmol/L): 1.7±0.5 vs. 2.8±0.6, scores of the vasoactive agents: 3.18±1.01 vs. 4.48±1.50, allP < 0.05], mechanical ventilation time and the length of ICU stay were less than those in the control group (hours: 16.52±6.41 vs. 21.96±9.00, 45.51±9.36 vs. 51.76±13.66, bothP< 0.05). There was no significant difference in SOFA, hospitalization time between the two groups. There was negative correlation with Pv-aCO2 and CI (r = -0.752,P < 0.01), and no correlation with Pv-aCO2 and Lac (r = -0.154,P = 0.171).Conclusion Pv-aCO2 combined with PLR can better guide volume management in the patients post OPCABG, reduce the usage of vasoactive agents and decrease the mechanical ventilation time and the length of ICU stay.

objective To investigate the ability of insulin sensitivity index HOMA2-%S and secretion function index HOMA2-%B calculated by HOMA2,the new homeostasis model assessment,in clinical application. Methods Eighty female volunteers with polycystic ovary syndrome in Chongqing area [50 subjects with normal glucose tolerance(NGT group)and 30 subjects with impaired glucose regulation(IGR group)]were involved in this study.Thev underwent a 75 g oral glucose tolerance test(OGTF)and the Botnia clamp test. From the data of faming blood samples in OGTF,insulin sensitivity index HOMAI-ISI,secretion function index HOMAl-β and disposal index DI-HOMA1 were calculated by the old homeostasis model assessment(HOMA I),meanwhile insulin sensitivity index HOMA2-%S,secretion function index HOMA2-%B and disposal index(DI-HOMA2) were caleulated by the new homeostasis model assessment (HOMA2).Correlation coefficients between insulin sensitivity index and GIR (the glucose infusion rate at steady state of Botnia clamp test),and between insulin secretion function index and AIR(the acute insulin response in Botnia clamp test),were studied.Results The Pearson's linear correlation coefficient between HOMA2-%S and GIR(r=0.503),HOMA1-ISI and HOMA2-%S (r= 0.990).HOMA2-%B and AIR(r=0.382),HOMA1-B and HOMA2-%B(r=0.976) were all statistically significant(a11 P<0.01).The glucose disposal indexes calculated from the HOMA2 and HOMA1 of 1GR group were significantly lower than those from the NGT group(t=2.825,P<0.Ol;t=2.222,P<0.05). Conclusion The HOMA2 is a better model in evaluating the insulin sensitivity and secretion function and is recommended to be widely used in clinical evaluation.

Objective To study the middle ear mucosa of guinea pigs with tympanosclerosis by electron microscope and try to obtain some insights into the feature and pathogenesis of tympanosclerosis.Methods Eight healthy variegated guinea pigs were devided into 2 groups.Six(8 ears) guinea pigs were subjected to inoculation of 1×10~8/L of staphylococcus aureus solution 100 μl into the middle ear cavities under the microscope.All the guinea pigs were observed for more than 6 months with no farther treatment.For electron-microscopic studies,the mucosa tissues were taken from the tympanic mucosa in 6 guinea pigs (8 ears) with tympanosclerosis from various sites,while the middle ear mucosa of two healthy guinea pigs (4 ears) were taken as a control.Results Uhrastructural examination of the normal middle ear mucosa revealed a few collagen fibers,normal morphous of fibrocyte,rough endoplasmic reticulum and mitochondria,and there was no lysosome.However,the tympanosclerosis specimens showed that irregular deformation,elongation,and degeneration of fibrocytes and oval nucleus were darkly stained,lots of mitochondria and lysosomes gathered into the cytoplasm around the nuclear and cystic expansion of the endoplasmic reticulum.In the submucosa extracellular matrix,there were a large number of collagen fibers containing lots of amorphous high-density electron-rich body.Conclusion Electron-microscopic studies of the middle ear mucosa of guinea pigs with tympanosclerosis revealed evident proliferation of collagen fibers,and calcifications were seen in the structures such as extracellular matrix vesicle,lysosomes,myelin structures within lipid granules,which mainly in extracellular matrix vesicles.

To know the characteristics of Shuxuening injection used on cerebral infarction patients in clinical practice, 6 053 cases of Hospital information system (HIS) data from 20 hospitals were analyzed. Using the basic description method and association rules to analysis the data. By analysis the data we found that the average age of cerebral infarction patients who used Shuxuening injection is 67.96, 83.94% of patients were aged 46-80. The injection is administered intravenously,with most patients receiving a dosage of 15-20 mL per dose for between 1 and 14 days. It is always combined with aspirin (48.508%), cinepazide maleate injection (22.073%), atorvastatin calcium tablets (18.873%) in clinical practice. When it comes to two drug combinations, it always combined with cinepazide maleate injection and aspirin (8.178%), nicergoline capsules and aspirin (7.63%). Therefore, based on existing data, we give the conclusion that for the treatment of cerebral infarction Shuxuening injection is mainly used for older patients, and is often combination with similar pharmacological effects chemical drugs, which is complied with the guidelines. However, the wrong dose is still exist, doctors should realize the hiding risk.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Anticoagulants ; therapeutic use ; Aspirin ; therapeutic use ; Atorvastatin Calcium ; Cerebral Infarction ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Heptanoic Acids ; therapeutic use ; Humans ; Male ; Middle Aged ; Piperazines ; therapeutic use ; Pyrroles ; therapeutic use ; Young Adult

To explore the characteristics and influenced factors associated with the onset of vertigo disease, analysis of 3 719 cases of hospitalized patients with vertigo disease from the real world. Analysis the date of patients diagnosed with vertigo disease from the hospital information system of 19 grade-III class-A hospital from 2004 to 2011, include general information, the doctor's advice, other diseases combined, diagnostic information and the relationship with the onset of 24 solar terms, and the treatment drugs. The median age of hospitalized patients with vertigo disease was 59, the number of women (65.91%) was more than men (34.09%), manual workers (85.32%) were the majority career, most patients (81.63%) condition were general by the time they were hospital admission, patients more like admitted to neurologist (70.34%) when they first time to outpatient serves, hospitalization days were in 8-14 days (46.65%), 46.04% of the patients in the hospital total cost is in 5 000 RMB to 10 000 RMB, 73.86% of patients paid by National Health Medical Insurance. Hypertension (20.79%) was the most common underlying health problems, The most common syndromes was deficiency of liver-Yin and kidney-Yin(44. 21%) , followed by hyperactivity of liver-yang, disease of phlegm turbidity in mongolia and deficiency of Qi and blood. There were more deficiency syndrome and less excess syndrome. The highest rate of hospital admission solar terms in 2009 was the insects awaken throttle (5.21%), In 2010, the highest rate solar terms of hospital admission was the rain throttle (6.14%). The most frequently used traditional Chinese medicine was gastrodine injection (20.55%), the most frequently used western medicine for betahistine (10.19%), gastrodine injection was the most traditional Chinese medicine that combination with other western medicine. Hypertension was the most underlying health problems in the patients with vertigo disease in the real world, although the mental factors should also be attention. Liver was the most closely internal organs with vertigo, and solar terms in spring was the highest-frequency time. Gastrodine injection was the most commonly used traditional Chinese medicin in clinical to treat vertigo diserse, the therapeutic regimen combining with traditional Chinese and western medicine has more advantages. We should pay more attention to the guidance of Chinese medicine "syncretism between heaven and man", to keep up with the rhythm of change, adapt to the changes in the human body growth and decline of the Yin and Yang, by adopting the method of syndrome differentiation in traditional Chinese medicine to prevention and treatment vertigo disease.
Adolescent ; Adult ; Aged ; Benzyl Alcohols ; therapeutic use ; Betahistine ; therapeutic use ; Diagnosis, Differential ; Female ; Glucosides ; therapeutic use ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Middle Aged ; Vertigo ; diagnosis ; drug therapy ; epidemiology ; Young Adult