Objective To evaluate the effect for the treatment of severe asthma. Methods The data of 47 patients with severe asthma who were admitted to emergency department were retrospectively anayzed. Results Of total 47 patients ,45 were rescued, with the survival rate of 95.7%. Arterial blood gas was improved after treatment (P < 0.01). Conclusion Appropriate commencement, mode, strategy, and early weaning of mechanical ventilation, combined with the administration of bronchodilators and eorticosteroids are the important way to rescue patients with severe asthma.

OBJECTIVE To investigate syphilis serology detection methods suitable for high risk group. METHODS Treponema pallidum(TP-ELISA) and toluidine red un-hoated serum test(TRUST) combined screening methods were taken for sexually transmitted disease(STD) patients and suspicious cases with dirty sexual intercourse,and all the positive results were further confirmed by TPPA method. RESULTS The detection rate of TP-ELISA or TRUST method alons was 18.3% or 13.7%,respectively.The detection rate of the both methods was 20.8%.A percent of 12.0% in 108 cases that were detected positively by the combined screening methods were proved to be false positive by TPPA. CONCLUSIONS The combined screening methods of TP-ELISA and TRUST can reduce the escaping rate,while TPPA can exclude the false positive cases in screening period.Sensitivity and accuracy of syphilis detection can be ensured by taking TP-ELISA and TRUST combined screening with TPPA confirmation methods,which are without high cost and suitable for high risk group.

Objective To Apply appropriate dose of Glutamine(Gln)(300mG/d)for patients with acute cerebral infarction,and observe its preventinG and curinG function to the stress ulcer. Methods Sixty cases patients of acute cerebral infarction were observed and divided into the conventional treatment Group( 30 cases),Glutamine treatment Group( GLU,30 cases). Gastric pH value of patients was tested before treatment and after one week treatment. The stool or vomit occult blood positive( OB+)number of patients within one week, OB( +) duration and the number of patients need blood filterinG were observed. Results There was no siGnificant difference between the conventional treatment Group and the GLU Group in the Gastric juice PH value before treatment(t=0. 647,P>0. 05). After one week treatment,the Gastric juice PH value of the GLU Group was siGnificant hiGher than the conventional treatment Group(t=5. 25,P<0. 05);the number of OB( +)of GLU Group were less than the conventional treatment Group,but there was no statistical siGnificant difference(χ2=0. 577,P>0. 05);the OB( +)duration of GLU Group was less than the conventional treatemnt Group,and there was satistical siGnificant difference(t =4. 768,P <0. 05);the number of blood filterinG of GLU to treat stress ulcer was less than conventional treatment Group,and there was satistical siGnificant difference(χ2=l. 0l6,P>0. 05). Conclusion SupplementinG appropriate dose of Glutamine in patients with acute cerebral infarction can reduce the incidence of stress ulcer,decrease medical expenses.

Objective To study the method and therapeutic efficacy of the combined iliac screw with pedicle screw system internal fixation and one-stage anterior interbody autograft with iliac crest bone after focal cleaning in lumbosacral tuberculosis. Methods We summarized our 12 cases with lumbosacral tuberculosis treated using iliac screw combined with pedicle screw system internal fixation and one-stage anterior focus elimination plus iliac crest bone grafting during 3 years. Results All the incisions were healed by first intention. All patients can off-bed activity wearing lower back protector two weeks after operation and above eight months after operation,the follow up X-ray film showed all bone-grafts obtained solid fusion. Conclusion It was a safe and reliable method to treat lumbosacral tu-berculosis by using ilisc screw combined with pedicle screw system internal fixation and one-stage anterior focus elimi-nation plus iliac crest bone grafting.

Objective To explore the causes of pulmonary infection of stroke patient during recovery period. Methods 122 stroke patients combined with pulmonary infection in neural rehabilitation department from January 2008 to July 2011 were analyzed for the relative causes according to clinical nursing. Results Repeated pulmonary infection was correlated with dysphagia and tracheotomy of acute stage (P<0.05); Bilateral pulmonary infection was correlated with dysphagia, tracheotomy of acute stage and age (P<0.05). Conclusion Pulmonary infection is correlated with dysphagia, tracheotomy of acute stage and age in sequence.

Objective To investigate the frequencies of genotype and allele distribution of IL-12A gene single nucleo?tide polymorphisms (SNP) rs568408 and IL-12B gene SNP rs3212227 in Zhuang populations in Guangxi, and to compare the distribution of IL-12A and IL-12B polymorphisms among different races. Methods The IL-12A SNP rs568408 and IL-12B SNP rs3212227 were detected by SNaPshot SNP genotyping technique in 165 Zhuang people in Guangxi, frequen?cies of genotype and allele of IL-12A gene rs568408 and IL-12B rs3212227 polymorphisms were analyzed in Zhuang popu?lations compared with the other four populations(HapMap-HCB, HapMap-JPT, HapMap-YRI, HapMap-TSI)from Hap?Map database. Results There were polimorphisms of IL-12A and IL-12B gene in Zhuang populations in Guangxi. The fre?quencies of allele and genotype distribution of IL-12A gene rs568408 polymorphisms were not significantly differenct com?pared with HapMap-HCB, HapMap-JPT and HapMap-TSI(P>0.05), but were significantly different compared with Hap?Map-YRI(P<0.01);The frequencies of allele and genotype distribution of IL-12B rs3212227 polymorphisms were not sig?nificantly differenct compared with HapMap-HCB and HapMap-JPT(P>0.05), but were significantly different compared with HapMap-YRI and HapMap-TSI(P<0.01). Conclusion There are significant differences in the frequencies of allele and genotype distribution of IL-12A gene rs568408 and IL-12B gene rs3212227 between Zhuang populations and other eth?nic populations, and this variation might contribute to a variety of clinical manifestation and morbidity of some IL-12 related diseases.

Objective To evaluate the predicting value of serum procaleitonin (PCT) in treatment of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in elderly patients. Methods A total of 267 elderly patients requiring hospitalization for AECOPD were randomly assigned into 2 groups: standard therapy group (standard group, n= 135) and PCT-guided group(PCT group, n= 132). Standard group received antibiotics according to the guideline of attending physicians and PCT group were treated with antibiotics according to serum PCT levels.Length of hospitalization, clinical efficacy, costs of hospitalization and antibiotics, rate of antibiotics use, hospital mortality, rate of exacerbation and rehospitalization, frequency of exacerbation within 1 year were observed. Results Length of hospitalization, clinical efficacy, hospital mortality, rate of exacerbation and rehospitalization, frequency of exacerbation within 1 year were similar in 2 groups(all P＞0.05);costs of hospitalization and antibiotics, rate of antibiotics use of PCT group[10 882 (3808-16 651)yuan, 6934 (2390-10 660)yuan, 76.5%] were lower than those of standard group[13 637(4650-19 730)yuan, 8589(3144-12 117)yuan, 87.4%] (all P＜0.05). Conclusions PCT guidance offers an advantage over standard therapy in reducing antibiotic use and in lowering the costs of hospitalization in treatment of AECOPD in elderly patients.

Objective To evaluate effect of en bloc resection of malignant sacral tumor involving partial sacrum and ipsilateral sacroiliac joint with reservation of contralateral sacral foramina.Methods Between February 2005 and July 2010,16 patients with malignant sacral tumor involving partial sacrum and ipsilateral sacroiliac joint underwent hemi-sacrectomy and functional reconstruction.The operation achieved en bloc resection of tumor with reservation of contralateral sacral foramina.There were 10 males and 6 females,aged from 17 to 70 years (average,37.9 years).There were 5 cases of chondrosarcoma,3 cases of Ewing's sarcoma,2 cases of malignant schwannoma,2 cases of osteosarcoma,1 case of malignant giant cell tumor of bone,1 case of lymphoma and 2 cases of metastatic tumor.Results The surgical time ranged from 4 to 11.5 hours (average,6.5 hours).The average blood loss was 3600 ml (range,1500 to 5500 ml).Five patients underwent type Ⅰ resection,while 11 patients underwent type Ⅱ resection.All patients were followed up for 21 to 59 months (average,34.4 months).Three months after operation,13 patients had difficulty with ankle plantar flexion,while sphincter function was more or less reserved in 16 patients.Four patients (25％)had wound healing complications,which was cured after debridement and drainage.Local recurrence occurred in 7 patients.There were 5 cases of local recurrence among 6 patients who had intralesional margin;4 recurrence lesions located in the sacrum and 1 in soft tissue.Eight patients (50.0％) survived without tumor,2 patients (12.5％)survived with tumor,and 6 patients (37.5％) died of tumor.Conclusion The en bloc resection of tumor involving partial sacrum and ipsilateral sacroiliac joint with reservation of contralateral sacral foramina was feasible and had better outcome compared with total sacrectomy.

Objective To discuss the value of Visfatin in severity evaluation in patients with severe pneumonia via observation on the variations of the plasma level of Visfatin. Method Seventy subjects including 40 patients with severe pneumonia ( group A) and 30 patients with non-severe pneumonia (group B) admitted to the ICU of emergency department and general wards from June 2009 to June 2010, were enrolled in this prospective study, and another 30 healthy individuals from physical examinees were included as subjects in control group (group C). Patients with severe diseases of heart, brain and kidney, cancers, autoimmune disease, or under special treatment in latest one month were excluded. For the subjects of all three groups, the plasma levels of Visfatin, IL-6, IL-8 and TNF-α were measured by using ELISA, while the level of CRP was assayed by using immunoturbidimetry, and the routine blood test was performed as well. The blood gas analysis and Acute Physiology and Chronic Health Evaluation Ⅱ ( APACHE Ⅱ) were carried out in patients with pneumonia. Comparisons between groups were made by t-tests, ANOVA or nonparametric test. Correlation analysis was carried out by Pearson correlation coefficient or Spearman rank correlation test. Results The plasma level of Visfatin in patients with severe pneumonia (group A) was significantly higher than that in patients with non-severe pneumonia (group B) and in the control subjects (group C) (P < 0. 01) , and the level of Visfatin in pneumonia ( group B) and in control group (group C) , and that in group B was significantly higher than that in the controls (group C) (P <0. 01). In group A, the plasma level of Visfatin was positively correlated with CRP, TNF-α, APACHE Ⅱ and PMN% (rha =0. 653, r = 0.554, r = 0.558, r= 0.484, P <0. 05), while negatively correlated with PaO2 and PaO2/FiO2 ( rha = -0.422, r= -0.543, P <0. 05). Conclusions Visfatin may be involved in the systemic inflammation response in severe pneumonia as a pro-inflammatory cytokine which is valuable in assessing the severity of pneumonia.

Objective To assess the safety and effectiveness of nasegastric enteral nutrition (NGEN) in patients with severe acute pancreatitis (SAP).Methods A meta-analysis of all the relevant clinical trials was performed.Clinical trials were identified from the following electronic databases:Medline,EMBASE,the Cochrane Controlled Trials Register,and Chinese Bio-medicine Database.The search was undertaken in October 2008.The literature quality was evaluated with Cochrane Handbook 5.0.The statistical analysis was performed by RevMan 4.2 software.Results Four trials involving 157 patients were included.The combined results showed that no significant differences in the safety and tolerance between nasogastric and conventional routes in patients with SAP.Conclusions Currently available data show early NGEN appears to be effective,safe,and tolerable in patients with SAP.However,more large-scale high-quality trials are required to further elucidate this topic.