Objective To realize the feature of drug resistance in elderly inpatients with tuberculosis in Tianjin. Methods The data of anti-tuberculosis drug sensitivity test of 296 elderly inpatients in Tianjin Haihe Hospital were collected from January 2008 to September 2009. And they were retrospectively analyzed compared with the non-elderly tuberculosis inpatients in the same period.Results (1)The 296 elderly patients with pulmonary tuberculosis were enrolled in this study. The total rate of drug resistance was 28.7% and total rate of multi-drug resistance was 8.8 %. The initial drug resistance rate was 22.2% and initial multi-drug resistance rate was 6.1%. The acquired drug resistance rate was 41.8% and acquired multi-drug resistance rate was 14.3%. (2)The order of drug resistance rate from high to low was isoniazid, streptomycin, rifampin and ethambutal, respectively.(3) The drug resistance rate did not show significant difference among different sex groups (x2 =0. 002, P＞0. 05). (4)The drug resistance rate and multi-drug resistance rate between elderly patients and non-elderly patients had significant differences (x2 = 10.8, 5.24, both P＜0.05). Conclusions The proportion of elderly patients with pulmonary tuberculosis is high, however, its drug resistance rate and multi-drug resistance rate are much lower than non-elderlies.

Objective To observe the effects of insulin pump therapy on type 1 diabetes mellitus children with diabetic keto or diabetic ketoa-cidosis(DK/DKA).Methods Forty-three children with DK/DKA were randomly divided into treatment group(n=26)and control group(n=17).The patients in treatment group were treated with insulin pump,control group were received small amount insulin injravenous injection.The changs of blood sugar,urine ketone bodies,incidence of hypoglycemia and length of stay were observed.Results 1.The effect of decreasing sugar was the same between two groups.2.There was no hypoglycemia events in treatment group.But 2 cases in control group had hypoglycemia.3.There was significant difference of length of stay between two groups(P

Objective To observe blood pressure variability(BPV) and analyze the correlation between BPV and carotid artery-intima media thickness (CA-IMT) in elderly hypertension. Methods Totally 156 patients with primary hypertension were divided into 3 groups:patients aged 45-59years (48 cases) 60-79 years (52 eases),and 80-94 years (56 cases).24 h ambulatory blood pressure monitoring (24 h ABPM) was used to measure 24 h mean systolic blood pressure (24 hSBP),24 h SBP standard deviation (24 h SBPSD),and to calculate 24 h SBP coefficient of variation (24 hSBP CV).Meanwhile,SBP of daytime (DSBP) and nighttime (NSBP),DSBPSD and NSBPSD were measured,and DSBPCV and NSBPCV were calculated.CA-IMT was examined by ultrasound.Spearman rank correlation coefficient was employed to assess the relationship between above indicators and CA-IMT,age. Results No differences were found in 24 h SBP,DSBP and NSBP among the groups.24 hSBPSD( 14.3 ± 3.1),24 h SBPCV ( 11.5 ± 2.1 ),DSBPSD ( 13.8 ± 3.8),DSBPCV ( 10.7 ± 2.6),NSBPSD (13.4±3.3)of patients aged 80-90 years were higher than those of patients aged 60-79 years (12.2±2.5,10.1±2.0,11.6±2.6,9.5±2.3,11.9±2.8)and patients aged 40-59 years (11.7±2.8,9.4±1.9,10.9±3.1,8.4±1.8,11.6±3.0) (P＜0.05).NSBPCVof patients aged 80-90years was increased as compared with patients aged 40-59 years (10.9±2.7 vs.9.6±2.4,P＜0.05).24 h SBPSD,24 h SBPCV were associated with CA-IMT and age(r=0.26,0.39;0.28,0.42,all P＜0.01). Conclusions SBPSD and SBPCV of 24 h ABPM are higher in very older patient with hypertension and could be the useful markers for assessment of BPV.

Objective To observe the change of blood pressure variability (BPV)in elderly hypertension patients,and to analysis the correlation between BPV and stages of renal function damage.Methods 127 elderly primary hypertensive patients with chronic kidney disease(CKD) were divided into three groups:stage 2 CKD group (aged 60-90 years,n=50),stage 3 CKD group (aged 62-93 years,n=40) and stage 4 CKD group (aged 64-94 years,n=37),according to National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (K/DOQI) guide.24 h ambulatory blood pressure monitoring (24 hABPM) was used to measure 24 h mean systolic blood pressure (24 hSBP),24 hSBP standard deviation (24 hSBPSD),and to calculate 24 hSBP coefficient of variation (24 hSBPCV).Differences in above indicators among groups were analyzed by ANOVA.The relationship between above indicators and estimated glomerular filtration rate (eGFR),urinary albumin excretion rates(UAER) were assessed by Spearman rank correlation coefficient.Logistic regression analysis was employed to assess the relationship between BPV and the degrees of impaired renal function.Results 24 h SBPSD and 24h SBPCV were lower in stage 2 CKD group than in stage 3 CKD and stage 4 CKD groups [(11.91±2.56) vs.(13.98±2.89),(14.25±3.16);(9.79±2.01)vs.(11.28± 1.70),(11.53±2.65) ;all P＜0.05].24 h SBPSD,24 h DBPCV and 24 h diastolic blood pressure (24 hdBP) CV were negatively correlated with eGFR (all P＜0.01) and were positively correlated with UAER (all P＜0.01).Logistic regression analysis showed that 24 h DBPSD and 24h SBPCV were related to impaired renal function (both P＜0.05).Conclusions Blood pressure variability is increasing along with impairing renal function in elderly hypertensive patients.Blood pressure variability is associated with renal function damage.

Adolescent ; Adult ; Aged ; Cystitis ; etiology ; prevention & control ; Female ; Hematopoietic Stem Cell Transplantation ; adverse effects ; Hemorrhage ; etiology ; prevention & control ; Humans ; Injections, Intravenous ; Male ; Mesna ; administration & dosage ; therapeutic use ; Middle Aged ; Transplantation Conditioning ; methods ; Young Adult

Objective To explore the relationship between acceptance of disability and hope level in patients with total laryngectomy.Methods Totally 84 patients with total laryngectomy were recruited and investigated with the general information questionnaire,Acceptance of Disability Scale (ADS)and Herth Hope Index (HHI).Results The total score of ADS was (85.82±12.64),which showed medium level acceptance of disability.The total score of Herth Hope Index (HHI) was (35.50±8.12),which showed high level HHI.Significantly positive correlation was found between acceptance of disability and HHI.Conclusions Nurses should pay more attention to the acceptance of disability in patients with total laryngectomy,and provide effective psychological intervention to improve the patients' menial health and quality of life.

Objective To compare the similarities and differences of the five detection methods used in the detection of fungi in vaginal secretions,and find the most sensitive、the most specific、the fastest、the most cost effective and the simplest method used in the detection of fungi in vaginal secretions.Methods A total of 442 patients were selected from the Department of Gynecology of Shenzhen OCT Hospital from May 2016 to August 2016.The vaginal secretion of 442 specimens was detected by using the methods of fungi culture、saline and KOH suspension method,Gram stain,Wright''s stain and Vaginitis Multi Test Kit.In these five methods,Fungi culture were using as gold standard to evaluate the specificity,sensitivity,negative predictive value,positive predictive value and accuracy of the other four methods.Results Using the fungus culture method to detect 442 cases of vaginal secretion,we found the positive rate of mycotic infection was 34.8%(154/442).Compared with the fungi culture method,the Specificity of saline and KOH suspension method was 97.9%,the sensitivity was 64.9%,the negative predictive value was 83.9%,the positive predictive value was 94.3% and the accuracy was 86.4%;the Specificity of Gram stain was 96.5%,the Sensitivity was 83.1%,the negative predictive value was 91.4%,the positive predictive value was 92.7% and the accuracy was 91.8%;the Specificity of Vaginitis Multi Test Kit was 84.7%,the Sensitivity was 46.8%,the negative predictive value was 74.8%,the positive predictive value was 62.0% and the accuracy was 71.5%;the Specificity of Wright''s stain was 96.9%,the Sensitivity was 78.6%,the negative predictive value was 89.4%,the positive predictive value was 93.1% and the accuracy was 90.5%.Conclusion Gram stain could be the most sensitive and specific method in the four methods,with highest accuracy,and the the fastest,the most cost effective and the simplest method for the detection of fungi in vaginal secretions.The accuracy of detecting fungi in vaginal secretions could be improved by the combination of Gram stain method in clinical work.

Objective To discuss the clinical application and evaluate the effect of repairing finger injuries using the perforator flap in forearm cubital fossa.Methods From July,2012 to December,2013,8 cases of finger injuries with totaled defect area of 2.5 cm × 4.0 cm-5.5 cm × 7.0 cm were reviewed.Among them,6 cases had phalangeal fracture,7 cases had neurovascular injury and 4 cases combined with tendon injuries.Cubital fossa flaps based on the inferior cubital perforator of radial artery were transplanted to repair the defects.Results All of the 8 flaps survived.One of them experienced distal end necrosis of epidermis and 1 cm long wound dehiscence.But it was healed by dressing change.All of the 8 cases were followed up for an average of 11 months (range,6-20 months).Sensory quality of （S） + was present in all of the flaps with two-point discrimination ranging between 7.5 mm and 9.8 mm with an average of 8.5 mm.All flaps were seen with good appearance,texture and colour.Moreover,function and appearance in donor sites were satisfactory.Conclusion The perforator flap in forearm cubital fossa is a satisfying choice in repairing small skin defects in fingers and other paas in that it is fixed,easy to dissect and leaves small injuries in targeted area.

Objective To discuss the method and clinical effect of bilobed DIEP flap for repair of degloving injuries of the hand.Methods From June, 2013 to January, 2015, the bilobed DIEP flap were designed to repair 6 cases of degloving injuries of hand, of which the small leaf flap repaired separately defect of thumb, larger leaf flap repair 2nd-5th finger and palm and dorsum.The bilobed DIEP flap design were based upon anatomic study on deep inferior epigastric artery, superior epigastric artery, intercostal artery and its anastomosis.Results The largest area of main flap was 35 cm × 12 cm, and the deputy leaves of flap was 10 cm× 7 cm.All of the 6 flaps survived.One of them experienced distal end necrosis of epidermis.But it was healed by dressing changes.All of the 6 cases were followed up for average of 12 months (range, 6-20 months).All flaps were seen with good appearance, fully recovered protectve sensation and the active motion of the thumb was recovery.Moreover, the donor sites were closed directly and the appearance were satisfactory.Conclusion The bilobed DIEP flap is a satisfying choice in repairing degloving injuries of the hand in that it has reliable blood supply, can obtain the larger area of skin and leaves small injuries in targeted area.

Epithelial ovarian cancer is the most lethal gynecologic malignancy, drug?resistance will eventually appear after re?peated intermittent chemotherapy. However, second?line chemotherapy only works on a few patients, new drugs with better efficacy and less side effects are needed. There are a number of promising results of molecular targeted therapy in recent clinical trials for patients with recurrent epithelial ovarian cancer, such as Bevacizumab, Olaparib, Pazopanib, etc. They have been demonstrated to improve progression?free survival of patients with platinum?resistant ovarian cancer, which might become a new strategy for such patients. In this review, we summarized the current status and progress of targeted therapy for recurrent epithelial ovarian cancer.