Aged ; Humans ; Leukemia, Myeloid, Acute ; diagnosis ; therapy

Benzamides ; Humans ; Imatinib Mesylate ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; blood ; drug therapy ; Piperazines ; pharmacokinetics ; therapeutic use ; Pyrimidines ; pharmacokinetics ; therapeutic use

Objective To understand the clinical features and current therapies on asthma exacerbation,so as to provide practical evidence for managing asthma episodes. Methods Two hundred and fourteen school - age(≥6 years old)cases who were admitted for asthma exacerbation in Beijing Children's Hospital,from January 2005 to De-cember 2013,were enrolled. All the cases were categorized into 2 groups:asthma with pneumonia group(group A,n =88)and asthma group(group B,n = 126). Results There were 214 cases enrolled,the median age was 9(6 - 18) years old,and the male - female ratio was 1. 5: 1. 0,78. 0%(167 / 214 cases)of the patients enrolled had moderate asthma exacerbation,and 22. 0%(47 / 214 cases)were defined as severe episodes,7. 0%(15 / 214 cases)were on me-chanical ventilation. Compared with group B,group A had more systemic corticosteroids use(53. 4% vs 38. 9% ,χ2 =4. 416,P = 0. 036),higher proportion of cases needing mechanical ventilation(12. 5% vs 3. 3% ,χ2 = 5. 476,P =0. 019),longer durations in hospital(9. 0 d vs 8. 0 d,Z = - 3. 063,P = 0. 002),and higher hospitalization expenses (10 000 yuan vs 9 000 yuan,Z = - 2. 058,P = 0. 000). The prescription of Aminophylline didn't help to shorten the duration of wheeze days(5. 7 d vs 5. 9 d,t = - 0. 233,P = 0. 817). Twenty - four cases received bronchial lavage through bronchoscope during wheezing days,in which 22 cases(91. 7% )of wheezing disappeared within 3 days after the lavage. There were more sensitized allergens detected in those patients who showed hypersecretion status under bronchos-copy(3. 3 ±1. 4 vs 2. 2 ±1. 2,t =2. 190,P =0. 036),compared with those without such signs. Conclusions Pneumonia may increase the demand for systemic use of corticosteroids in asthma exacerbations. The early use of systemic corticoste-roids may have an effect on reducing the severity of asthma attack,especially those with pneumonia. Multi - sensitization may contribute to the hypersecretion in bronchi. The bronchial lavage may help improve the bronchial ventilation caused by mucous plugin. The clinical usage of Aminophylline is still controversial,and it needs to be optimized.

Objective:Sandplay themes and TAT stories of BPD's were deeply analyzed in order to explore the relationship between healing-trauma themes and need-pressure system.Methods:The healing-trauma themes of 30 BPD students' were compared with that of 30 non-BPD students'.A correlation analysis was done between healing-trauma themes and need-pressure system.Results:①Scores of trauma themes of BPD were significantly higher than those of normal participants(3.67?1.06/2.33?0.92,t=5.19,P

OBJECTIVETo explore therapeutic effects of minor external fixator for open comminuted phalangeal fractures with non-transarticular.

METHODSFrom January 2013 to December 2014,13 patients with open comminuted phalangeal fractures were treated by minor external fixator with non-transarticular, including 9 males and 4 females aged from 18 to 56 years old with an average of 35 years old. According to Gustilo classification, 8 cases were type II, and 5 cases were type III. The time from injury to operation ranged from 2 to 7 h averaged 5 h. Seven patients were diagnosed as phalangeal fracture, 6 patients were involved with joint surface of phalangeal, which 1 case combined with inherent nerve damage and 1 case combined with soft tissue defect repaired at stage II. The patients were fixed by plaster for 2 weeks and removal external fixtor from 6 to 8 weeks after operation and received functional exercise.

RESULTSAll patients were followed up from 3 to 12 months with an average of 7 months. One case occurred metacarpophalangeal joints stiffness. No screw breakage, inflammation occurred. Skin soft tissue recovered well and obtained bone healing, the average time of bone healing was (4.6 ± 1.0) weeks. According to TAM scoring system used by Hand Surery Association of Chinese Medical Association, 7 cases got excellent results, 4 good, 1 moderate and 1 poor.

CONCLUSIONMinor external fixator for open comminuted phalangeal fractures with non-transarticular has advantages of simple operation, good stability, and could adjust at the later stage, less damage for soft tissue periosteum, low inflammatory rate, earlier functional exercise. It is worth to be popularized and applied.

Adolescent ; Adult ; External Fixators ; Female ; Finger Phalanges ; injuries ; Fractures, Comminuted ; surgery ; Humans ; Male ; Middle Aged

OBJECTIVE:To study the correlation of inorganic elements and active ingredients in Paris polyphylla. METH-ODS:HPLC was adopted for contents determination of polyphyllinⅠ,Ⅱ,Ⅵ and Ⅶ:the column was Phenomenex C18 with mo-bile phase of acetonitrile-water(gradient elution)at a flow rate of 1.0 ml/min,detection wavelength was 203 nm,and column tem-perature was 30 ℃. ICP-MS was adopted for contents determination of Na,Mg,K,Ca,Cr,Mn,Fe,Ni,Zn,Se,Sr,Mo,Pb, Cd,Hg,Cu and As:RF power was 1.55 kW,sampling depth was 10 mm,the plasma gas flow was 15.0 ml/min,carrier gas flow rate was 0.86 L/min,spray chamber temperature was 2 ℃,helium collision mode was He,gas flow was 4.5 ml/min,measurement points/peak was 6,sampling mode was hopping peak collection(repeated 3 times). And SPSS 21.0 software was adopted for step-wise regression analysis of correlation between the two above-mentioned. RESULTS:The linear range was 0.939-4.697 μg(r=0.999 8)for polyphyllinⅠ,1.124-5.620 μg(r=0.999 6)polyphyllinⅡ,0.784-3.918 μg for polyphyllin Ⅵ,0.976-4.880 μg for poly-phyllinⅦ.RSDs of precision,stability and reproducibility tests were lower than 2%,recoveries were 96.53%-100.71%(RSD=1.69%,n=6) for polyphyllinⅠ,98.19%-99.55%(RSD=0.58%,n=6) forⅡ,95.45%-100.83%(RSD=1.87%,n=6) for poly-phyllin Ⅵ,96.11%-102.01%(RSD=2.07%,n=6)for polyphyllin Ⅶ . The linear range was 0-195.984 3 mg/kg(r≥0.999 3),de-tection limit was no higher than 65.201 ng/kg. PolyphyllinⅠshowed positive correlation with Mg and negative correlation with Pb;polyphyllin Ⅱ showed positive correlation with Cu and negative correlation with As;polyphyllin Ⅵ showed positive correlation with Sr and Hg and negative correlation with Mn;polyphyllin Ⅶ showed positive correlation with Na and Ni and negative correla-tion with As;the total contents of the 4 polyphyllins showed positive correlation with Ni and Sr and negative correlation with Fe. CONCLUSIONS:The contents of inorganic elements and P. polyphylla have certain correlation with active ingredient.

Objective To evaluate clinical outcome in postoperative patients with advanced gastric cancer treated with concurrent chemotherapy and dendritic cells (DCs) vaccine as well as alteration of immune function. Methods Sixty-four postoperative patients with advance gastric cancer were divided into control group and DC vaccine group, In control group, 38 patients were treated with LCH regimen consisted of 5-fluorouracil 0.75 g/d_(1-5) and oxaliplatin 0.2 g/d_1. In DC vaccine group,blood sample was obtained from 26 patients who were followed by LCH regimen treatment next day.One week after the chemotherapy, patients were immunized with DC vaccine for 2 times at interval of one week. The second cycle was performed after 28 days. The percentages of T lymphocytes and natural killer (NK) cells and cytokine levels before and after treatment were compared between two groups. The therapeutic effects (including no remote metastasis and enlarged lymph nodes in cavity and/or tumor reduced in volume) were also evaluated. Results The concentrations of T lymphocytes (CD3~+ and CD4~+ ), NK cells, interleukin (IL)-2, IL-12 and interferon-γ in DC vaccine group were significantly increased after vaccination compared with those before vaccination (P＜0.05), and even higher than those in control group (P＜0.05). The effective rate was higher in DC vaccine group (80. 76%) than that in control group (68.42%) with significant difference (P＜0. 05). The side effects of chemotherapy such as the decreased peripheral white blood ceils and immune cells were less serious in DC vaccine group compared with control group (P＜ 0.05), while the uncomfortable incidence of gastrointestinal tract and peripheral neuritis showed no significant difference between two groups (P＞0.05). Conclusions Application of concurrent chemotherapy and DC vaccine in patients with advanced gastric cancer after surgical treatment may achieve a short-term efficacy, meanwhile it can reduce the side effects induced by chemotherapy.

Objective To discuss the risk factors of ventilator-associated pneumonia (VAP) in intensive care unit(ICU).Methods From January 2008 to June 2010,the clinical data of 145 patients with mechanical ventilation over 48 hours in ICU were analyzed prospectively,and the effect was observed.Results There were a total of 53 patients with VAP,and the incidence was 36.6％ (53/145).Thirty-three cases died,and the fatality rate was higher than that in non-VAP patients [62.3％ (33/53) vs.30.4％ (28/92)],and there was significant difference (P ＜0.05).Related factors analysis results showed that indwelling gastric tube,the use of antiacids,mechanical ventilation time,nutritional status,age ≥ 60 years and chronic diseases were the risk factors of VAP (P ＜ 0.05 or ＜ 0.01).Conclusion VAP has many risk factors and higher fatality rate in ICU,and comprehensive prevention measures should be adopted to prevent the occurrence of VAP.

Objective:To examine whether somatostatin analogous(SSAs) have effect on Graves ophthalmopathy and to compare its effects with that of glucocorticoid.Methods: Both a computer aided search of MEDLINE and Chinese Biological Medicine disc and an intensive search by hand were conducted to identify all controlled studies assessing the effect of SSAs on Graves ophthalmopathy.Results: Five studies were finally included.Three of them found SSAs to be significantly more effective than placebo;2 of them found SSAs to be able to reduce proptosis; 2 of them found SSAs to be equally effctive as glucocorticoid.The pooled OR, pooled mean difference, pooled OR were 0.070.02,0.23],-1.47 -2.10,-0.84] and 0.95 0.25,3.59] respectively.Conclusion: This Meta analysis demonstrates that SSAs are effective in treatment of Graves ophthalmopathy and in reduction of proptosis, and it is equally effctive as glucocorticoid.

Diabetic foot infection may hamper wound healing and lead to non-traumatic amputation in diabetes patients and early diagnosis and proper treatment can improve prognosis.In this review,the progress in classification,influencing factors,diagnostic methods and local treatment of diabetic foot infection is introduced.