Objective To explore the risk factors for community-acquired pneumonia (CAP) in the elderly,in order to provide the basis for clinical prevention and treatment.Methods 168 elderly patients with CAP (observation group) and 100 elderly patients without CAP (control group) were chosen from our hospital from Jan.2013 to Dec.2014.The clinical data were investigated,and the risk factors for CAP were analyzed.Results Single factor analysis showed that there were significant differences between the two groupsin serum protein level,pets-raising,smoking,dust exposure,bronchial disease,renal dysfunction and diabetes mellitus (all P＜0.05).Multivariate logistic regression analysis showed that serum protein level,pets-raising,smoking,bronchial disease and diabetes were the independent risk factors for CAP in the elderly (OR=2.793,2.578,3.017,3.168 and 2.643,all P＜0.05).Conclusions The community-acquired pneumonia is related with many risk factors in the elderly.The clinical corresponding prevention and treatment for the risk factors should be developed,which have an important significance in the early diagnosis,early treatment and prognostic improvement in community-acquired pneumonia.

Objective: To establish the standard for quality control of Zhiganqing Granules (Radix et Rhizoma Rhei, Fructus Ligustri Lucidi, Rhizoma Alismatis, Pericarpium Citri Reticulatae, Polyporus Umbellatus, etc.) Methods: Fructus Ligustri Lucidi, Rhizoma Alismatis and Pericarpium Citri Reticulatae in the preparation were identified by TLC. The emodin in the preparation was determined by HPLC. A good linear range was shown at the concentration from 0.224?g to 0.732?g. The average recovery was 96.8% and the RSD was 1.14%.

Objective To report our laparoscopic and laparoscopic assisted urologic cases. Methods There were 33 laparoscopy cases,in 24 male and 9 female patients.The mean age were 4.6 years.Hypoplastic kidney were 5 cases,impalpable testis 14 cases,hydronephrosis 11 cases,duplicated kidney and duplicated kidney with ureterocole 1 case respectively,and pelvis stone 1 case.Retroperitoneal laparoscopic nephrectomy,heminephrectomy and pyelolithotomy ( 7 cases ),retroperitoneal laparoscopic assisted dismembered pyeloplasty ( 11 cases),laparoscopic orchiedopexy or orchiedectomy (14 cases),and laparoscopic pnuemovesical Cohens operation(1 cases) were conducted. Results 33 laparoscopic operations were completed successfully without conversion. Oral intake started on postoperative day 1.No serious complications occurred. Conclusions Laparoscopic techniques could be used for common pediatric urologic operations like hydronephrosis,impalpable testis ect.The surgical trauma and pain could be reduced and cosmetic effect improved.

Objective:To observe the effects of Naoxuekang oral liquid combined with nimodipine on hypertensive cerebral hemorrhage and the influence on serum Tau protein,IGF-1 and hs-CRP in the patients. Methods:Totally 98 patients with hypertensive cerebral hemorrhage were randomly divided into two groups(n = 49). The patients in the control group were given nimodipine,while those in the observation group were given nimodipine and Naoxuekang oral liquid at the same time,and all the patients received 4-week treatment. The serum levels of Tau protein,IGF-1 and hs-CRP before and after the treatment were detected,and the national institutes of health stroke scale(NIHSS)score,hematoma volume and curative effect and adverse drug reaction were recorded as well. Results:Before the treatment,there was no significant differences in Tau protein,hs-CRP, IGF-1,NIHSS score and hematoma volume between the two groups(P > 0. 05). After the treatment,the levels of Tau protein and hs-CRP,NIHSS score and hematoma volume in both groups were decreased,and those in the observation group were lower than those in the control group;the IGF-1 level in both groups was increased,and that in the observation group was higher than that in the control group;and all the differences had statistical significance(P < 0. 05). There was no significant difference in the complication rate between the groups( P > 0. 05),while the effective rate of the observation group was significantly higher than that of the control group(89. 8% vs 73. 5% ,P < 0. 05). Conclusion:Naoxuekang oral liquid combined with nimodipine can significantly reduce the serum levels of Tau protein and hs-CRP,and increase the serum level of IGF-1,and improve the symptoms of patients with hypertensive cerebral hemorrhage,which is beneficial to the rehabilitation of patients.

Objective To explore the differences among CT angiography(CTA) at different doses in both lower extremity arteries,and the relationship among volume rendering(VR) image quality,CT number and standard deviation(SD) value.Method CTA in lower extremity artery was performed in 90 patients.The participants were randomly divided into three groups,including a routine group (120 kV,150 mAs),120 kV and 80 mAs group,and 100 kV and 130 mAs group with 30 cases in each group.The images were processed with VR and classified into three degrees,the first class,the second class and the third class,and VR image quality levels of three groups were compared.The receiver operating characteristic curve(ROC) was used to analyze the correlation among VR image quality level,CT number and SD value.Results The percentage of VR image level at the first class was 93.3％ in the routine group,86.6％ in the 120 kV and 80 mAs group and 96.6％ in the 100 kV and 130 mAs group.According to the correlation analysis between the SD value and VR image quality of CTA in lower extremity artery,the area under curve in ROC analysis was 0.9078.According to the correlation analysis between the CT number and VR image quality of CTA in lower extremity artery,the area under curve in ROC analysis was 0.9116.Conclusions The low-dose CAT in lower extremity artery is feasible.Application of 100 kV and 130 mAs could ensure better image quality.

Objective To study the predetermination value of multi-slice spiral CT for showing the major blood vessels,bile and pancreatic ducts around normal duodenal papilla before EST.Methods A 16-slice spiral CT was used to perform 28s and 68s enhanced scan for normal structures surrounding duodenal papilla in 30 subjects.Post-processing was done to the raw data with thin-slice maximum intensity projection (TSMIP) and thin-slice average intensity projection (TSAIP),and then the structure of bile and pancreatic ducts,duodenal artery and pancreatic-duodenal conjunction were reconstructed.The reconstructed images were double-blind evaluated.Distances between papilla and upper,front,and behind edge of the pancreatic-duodenal conjunction,situation of the duodenal papilla artery and the distance from the papilla artery end to the papilla were recorded.Results After dual-phase enhanced scan,the post-processing results for the images of the surrounding structure of pancreatic and duodenal papilla were stable and the results of double-blind evaluation were consistent.Image scores of the arteries surrounding duodenal papilla and pancreatic duct at 28th second were significantly higher than those of 68th second,whereas bile duct and the ampulla structure image scores of 68th second were higher.TSMIP of local vascular structure could display anterior-superior pancreatic-duodenal artery (ASPDA) in 93.3％ of the subjects,posterior-superior pancreatic-duodenal artery (PSPDA) in 73.3％,inferior pancreatic-duodenal artery (IPDA) in 73.3％,duodenal-papillary artery (DPA) in 56.7％,bile duct in 96.7％,pancreatic duct in 90.0％ aud pancreatic and duodenal parenchima in 100.0％.The DPAs all started from PSPDA origin and down to papilla,with only 2 cases of 30 (6.7％) reached the upper edge of the duodenal papilla.Others showed arteries turned thin obviously at 12 mm above the papilla; the normal common bile duct can be tracked to the opening of the papilla.The Coronal Oblique TSAIP imaging showed the distance from the duodenal papilla-bile duct ending to the lower edge of the pancreatic-duodeual upper conjunction was 15.7±1.9 mm.Distance from papilla to the front edge of pancreatic-duodenal conjunction was 16.6±3.2 mm and to the behind edge was 1.7±0.4 mm.Distance (depth) from the inner edge of the papilla to the bile-pancreatic conjunction was 8.0±1.7 mm.Conclusion The 3D reconstruction of the Multi-slice spiral enhancement CT Imaging can providc high quality images of relative vascular,bile-pancreatic and obvious surrounding structures to the forthcoming operation.Massive hemorrhage and perforation risks of EST can be evaluated based on the vascular distribution and directions around duodenum and pancreas and the bile duct imaging.

Objective Through the correlation study of fibroblast growth factor 23 (FGF-23) and chronic heart failure to investigate the pathogenesis of chronic heart failure and provide a new method for chronic heart failure diagnosis.Methods One hundred and twenty-eight chronic heart failure patients (chronic heart failure group) were involved in this study.According to the level of left ventricular ejection fraction (LVEF),they were divided into LVEF slightly lowing group (LVEF 40％-50％,50 patients),LVEF moderately lowing group (LVEF 30％-39％,35 patients),LVEF severely lowing group (LVEF ＜30％,43 patients).Fifty healthy people was as control group.The level of FGF-23,parathyroid hormone (PTH),creatinine (Cr),urea nitrogen (BUN),blood calcium,blood phosphorus,N-terminal pro-B-type natriuretic peptide (NT-proBNP) were detected.The patients in two groups were performed color Doppler ultrasonography.Results The level of FGF-23,blood phosphorus,PTH,left ventricular mass index (LVMI),NT-proBNP in chronic heart failure group were significantly higher than those in control group [68.44(55.85-94.73) ng/L,34.18(30.57-38.87) ng/L,(1.13 ± 0.13) mmol/L vs.(1.02± 0.12) mmol/L,(15.51 ± 3.99) ng/L vs.(9.97 ± 0.89) ng/L,(112.27 ± 52.02) g/m2 vs.(71.37 ± 12.95) g/m2,(6 265.3 ± 15 991.6) ng/L vs.(76.12 ± 51.80) ng/L](P ＜ 0.01).The level of blood calcium,glomerular filtration rate (GFR) in chronic heart failure group were significantly lower than those in control group [(2.28 ±0.16) mmol/L vs.(2.48 ±0.13) mmol/L,(78.28 ± 14.20) ml/ (min ·1.73 m2) vs.(85.03 ± 14.44)ml/ (min·1.73 m2)] (P ＜ 0.01).Spearman correlation analysis showed that FGF-23 had positive correlation with age (r =0.256,P ＜0.01),blood phosphorus (r =0.326,P ＜0.01),PTH (r =0.584,P ＜0.01),NT-proBNP (r =0.799,P ＜ 0.01),LVMI (r =0.540,P ＜ 0.01),and had negative correlation with blood calcium (r =-0.308,P ＜ 0.01),GFR(r =-0.527,P ＜ 0.01).The level of FGF-23 was increased when LVEF reduced.Conclusions It has significant correlation between the level of FGF-23 and the degree of chronic heart failure.It suggests that the level of FGF-23 can evaluate the myocardial systolic function and ventricular remodeling.

Autoimmune Lymphoproliferative Syndrome ; diagnosis ; genetics ; immunology ; therapy ; Biomarkers ; blood ; Child, Preschool ; Humans ; Male ; Mutation ; Prednisolone ; administration & dosage ; therapeutic use ; Ultrasonography, Doppler, Color ; fas Receptor ; genetics

Breast Neoplasms ; classification ; genetics ; metabolism ; pathology ; Chromosome Aberrations ; Female ; Gene Deletion ; Humans ; Phyllodes Tumor ; classification ; genetics ; metabolism ; pathology ; Twist-Related Protein 1 ; metabolism ; Wnt Signaling Pathway

Objective: To observe the clinical effects of a modified Tuina method in the treatment of childhood diarrhea. Methods: Thirty children with diarrhea of spleen deficiency were treated by Four-Step Tuina(treatment group); and control group was treated with routine Tuina methods. The scale of children diarrhea was used as an objective index for therapeutic effect evaluation. Results: After treatment, the scale was 1.4±1.92 in treatment group and 3.3±3.45 in control group; the statistical analysis showed that there was a difference between the scales; the treatment group had better effects than control group, in another word, the Four-Step Tuina was quite effective for children diarrhea. Conclusion: Tuina has positive effects on children diarrhea of spleen deficiency, which provides evidences for the standardization of clinical therapeutic effects.