Adult ; Cardiac Catheterization ; adverse effects ; Female ; Heart Septal Defects, Ventricular ; surgery ; Hemolysis ; Humans ; Postoperative Complications ; etiology

OBJECTIVE:To observe the efficacy and safety of olanzapine combined with ziprasidone in the treatment of refrac-tory schizophrenia in elderly patients. METHODS:120 elderly patients with schizophrenia were randomly divided into control group and study group. Control group was orally treated with Olanzapine tablet 10-20 mg,once a day;study group was orally treat-ed with Ziprasidone hydrochloride capsule 80-120 mg,twice a day+Olanzapine tablet(the usage was the same as control group). The clinical efficacy in 2 groups was evaluated after 2 weeks,PANSS score,FPG,2 h PG,TC,TG,HDL-C,LDL-C,body weight, BMI before and after treatment and incidence of adverse reactions were observed. RESULTS:There were no significant difference in the total efficacy and incidence of adverse reactions between 2 groups(P>0.05). After treatment,the PANSS scores at different time point in 2 groups were significantly lower than before,and 12 weeks<8 weeks<4 weeks<2 weeks,the differences were sta-tistically significant(P<0.05),however,there was no significant difference between 2 groups(P>0.05). There were not signifi-cant differences in the indexes of blood glucose and lipid,body mass and BMI in study group before and after treatment (P>0.05);after treatment,the blood glucose after 8 and 12 weeks and LDL-C,TG,TC,body mass and BMI after 4,8 and 12 weeks in control group were significantly higher than before and study group same time,the HDL-C was significantly lower than before and research group,the differences were statistically significant(P<0.05). CONCLUSIONS:The efficacy and safety of both olan-zapine combined with ziprasidone and olanzapine alone in the treatment of refractory schizophrenia in elderly patients is similar, however,it is better than olanzapine alone in terms of controlling blood glucose and lipid.

Endovascular therapy has become a research focus for the treatment of acute ischemic stroke,mainly including intra-arterial thrombolysis,combined intravenous and intra-arterial thrombolysis,mechanical recanalization,angioplasty and stenting,etc.This article reviews the evidence of evidence-based medicine of endovascular therapy in patients with acute ischemic stroke.

Objective To investigate the clinical efficacy of sequential plasma perfusion of low dose plasma exchange in the pa-tients with acute on chronic liver failure (ACLF).Methods The patients with HBV related ACLF in the infection department of the Affiliated Hospital of Luzhou Medical College were divided into the plasma exchange therapy group (group A,n=114)and the low dose plasma exchange sequential plasma perfusion therapy group (group B,n=144).The group A was treated only by plasma exchange of fresh frozen plasma 2 400 mL;while the group B adopted the sequential plasma perfusion of plasma exchange,with fresh frozen plasma dosage of 1 400 mL.The changes of the liver and renal function,coagulation function and electrolyte indicators were observed in the two groups.The differences in the clinical effects and adverse reactions were compared between the two groups.Results The serum levels of ALT,TBIL and INR after treatment in the two groups were significant decreased than before treatment(P<0.05);ALB and PTA were significantly improved compared with before treatment(P<0.05);there were no signif-icant differences in serum levels of CRE,K+ and Na+ between before and after treatment.The changes of various indexes before and after treatment had no statistical differences between the two groups.The total effective rate and the mortality at 24 weeks in the group B was 66.66% and 47.22% respectively,which had no statistical differences compared with the group A.The total oc-currence rate of adverse reactions in the group B was 23.75%,which was significant lower than 35.26% in the group A with statis-tical difference (P=0.011).Conclusion Sequential plasma perfusion of plasma exchange has better clinical effect and few adverse reactions for treating the patients with ACLF,which can reduce the plasma dosage significantly.

OBJECTIVE: To investigate the feasibility and results of laryngeal functional preservation surgery for piriform sinus carcinoma with paraglottic space involvement. METHOD: Fourteen cases of piriform sinus carcinoma with paraglottic space involvement were reviewed. Laryngoplasty was performed after tumor was resected, bilater al selective neck dissections were performed at the same stage. Postoperative chemoradiotherapy was applied to 11 patients while the other 3 patients did not receive chemotherapy nor radiotherapy. The follow-up time ranged from 6 months to 5 years, and the mean follow-up time was three and a half years. RESULT: Twelve cases healed primarily while 2 cases experienced delayed heal because of pharyngeal fistula. Postoperative swallow bucking occurred in all patients, the longest gastric feeding time was 2 months. For the patients underwent postoperative chemoradiotherapy, the tumor did not recur in ten cases during the 3 years follow-up, while recurred in another case and the patient died without further treatment. Among those 3 cases without postoperative radiotherapy or chemotherapy, the tumor recurred in 2 cases during the following 6 months and chemoradiotherapy was applied, no recurrence presented in one patient, another one lost of follow-up. For the patient with recurred tumor 8 months after surgery, total laryngectomy was employed with postoperative chemoradiotherapy, the case died of tumor recurrence one and half year after the first surgery. The 3-year survival rate was 78.6%. For the vocal cord at lesion side, the mobility was noticeable in 6 patients, and visible anatomic landmark was lost in the other 8 patients. CONCLUSION Laryngeal function preservated surgery could be performed in selected cases of piriform sinus carcinoma with para-glottic space involvement in order to achieve better clinical results and quality of life.
Aged ; Carcinoma ; surgery ; Female ; Follow-Up Studies ; Glottis ; Humans ; Hypopharyngeal Neoplasms ; surgery ; Larynx ; physiology ; Male ; Middle Aged ; Organ Sparing Treatments ; Pyriform Sinus ; pathology ; Retrospective Studies ; Treatment Outcome

Adult ; Angioplasty, Balloon ; methods ; Arteriovenous Malformations ; complications ; therapy ; Heart Septal Defects, Ventricular ; complications ; therapy ; Humans ; Jugular Veins ; Male ; Vena Cava, Inferior ; abnormalities

Apolipoprotein A5(ApoA5)level and other indices were determined in patients with type 2 diabetes mellitus and healthy individuals.Compared to control group,ApoA5 level in the diabetic group was lower (P

It is to difficult to diagnose and treat hepatobiliary surgical diseases since its diverse clinical manifestations,which increases the difficulty of clinical internship.Taking clinical cases as teaching material,case-based learning was combined with teaching theme and was conducted by means of discussion and question and answer between teachers and students.Students can know about concepts or theories related to teaching theme.Case-based learning in internship can consolidate basic knowledge of hepatobiliary surgery,cultivate clinical scientific thinking and is helpful in analyzing and resolving problems of hepatobiliary surgical diseases.

Objective To study the MRI findings of HE and the pathological mechanism and to improve the diagnosis and differential diagnosis of HE. Methods Five patients of HE diagnosed by clinical and laboratory examination were examined with conventional MRI scan. Additional DWI, MRA and enhancement MRI scan were performed on 3 patients in which abnormal findings was detected on the conventional MRI. The distribution of lesions and signal characteristics were analyzed. The ADC values of the lesions and of the contralateral non-lesion area were measured. Moreover, the possible pathological mechanisms of HE were discussed on the basis of changes of clinical and imaging manifestations in the two cases with serial clinical and MRI data. Results Of 5 patients, brain abnormalities were found in 3 cases,which showed scattered spotted supratentorial white matter lesions of isointensity on T1 WI and DWI, and high signal intensity on T2WI and fluid-attenuated inversion recovery (FLAIR). Meanwhile, multiple plaque-like lesions involving both white matter and gray matter were found, mainly located at the basal ganglia nuclei, hippocampus and cingulate cortex. The lesions demonstrated iso-or hypo-intensity on T1 WI,and iso-or hyper-intensity on T2 WI, FIAIR and DWI at the initial stage. No enhancement was found in these lesions and MRA disclosed no remarkable findings. The ADC value of the lesions [ (0. 449 ± 0. 092) ×10-3 mm2/s] was decreased significantly compared with the contralateral noninvolved area [ (0. 838 ±0. 062) × 10-3 mm2/s] at the early onset. In 2 cases with glucocorticoid therapy, together with symptom relief, MRI follow-up scan demonstrated the reduction of lesion volume, the signal change to hyperintensity on T1 WI and hypo-intensity on DWL The ADC of the lesions increased significantly. Conclusion The MRI could be one of the effective tools for diagnosis, differential diagnosis, and judging the prognosis and therapeutic results of HE. Meanwhile, it may be a non-invasive method to study the pathological mechanism of HE.

Antimony ; blood ; Humans ; Spectrophotometry, Atomic ; methods