Adenoma ; pathology ; Carcinoma, Renal Cell ; pathology ; Diagnosis, Differential ; Female ; Humans ; Kidney Neoplasms ; pathology ; Middle Aged

Objective To provide an effective basis for clinical control methods of multi-drug-resistant bacterial (MDRB) infections by analyzing the distribution and antimicrobial resistance of MDRB.Methods The French Merieux ATB Expression Automated Analysis System was used for bacterial identification,whereas a drug susceptibility testing was performed by K-B methods.Drug-resistance rate was calculated,and the predisposing factors were analyzed.Results Altogether 811(8.1％) strains were isolated from 9 954 specimens,and the majority of multiply antimircobial-resistant bacteria were Escherichia coli,Coagulase-negative staphylococci,Klebsiella Pneumoniae Staphylococcus aureus,Acinetobacter Baumannii,Pseudommonas aeruginosa,whereas the last two appeared pan resistant strains.Specimen source was mainly from respiratory specimens,accounted for 47.8％,and was mainly distributed in the ICU unit,atout41.8％ ;MDRB enterobacter was highly sensitive to Carbapenems with resistance rates less than 1.5％ and to Amikacin and other inhibitor drugs that rate was less than 30.0％.The resistance rates of MDRB nonfermentative bacteria was ＞ 77.0％ to Carbapenem antibacterial drugs whereas to non-resistance was found to polymyxin and only 20.0％ resistance rate to Cefoperazone/sulbactam.MDRB staphylococcus was 100.0％ sensitive to Vancomyci,Teicoplanin and Linezolid and less sensitive (＜ 30.0％) to chloramphenicol and rifampicin.MDRB showed high resistance rate to other antibacterial drugs.The predisposing factors included age,other disease,hospitalization over two weeks,the usage of multiply antimicrobial especially cephalosporins overtoppinh 7 days,and invasive operations.Conclusion The major MDRBs are resistant to common-used antimicrobial drugs.It is nesessary to pay attention to the differences.

Objective To investigate the effects of ulinastatin on serum concentrations of advanced oxidation protein products and C-reactive protein in patients with multiple organ dysfunction syndrome(MODS).Methods Seventy-two patients with MODS were randomly divided into ulinastatin group(n=36) and control group(n=36).The serum concentrations of advanced oxidation protein products and C-reactive protein in two groups were determined before therapy and after 3d,5d and 7d of therapy.Acute physiology and chronic health evaluation Ⅲ (APACHE Ⅲ)for patients were recorded before therapy and after 3d,5d,7d of therapy.Mortality within 28d was also compared between the two groups.The serum concentrations of advanced oxidation protein products and C-reactive protein in 36 healthy volunteers were detected as normal control.Results The concentrations of AOPP and CRP in patients with MODS before therapy were significantly higher than those obtained from healthy volunteers(P<0.05), whereas no obvions difference was found between the two groups.However,the levels of AOPP and CRP in patients with MODS were significantly decreased after 3d,5d,7d of therapy.Compared with control group,AOPP concentrations and CRP levels were markedly attenuated and APACHE Ⅲ scores decreased significantly in ulinastatin group(P<0.05).The mortality in ulinastatin group was also improved more significantly than that in control group(P<0.05).Conclusion Ulinastatin can decrease the concentrations of serum AOPP and CRP in patients with MODS,so as to alleviate the damage resulting from oxidative stress and inflammation,contributing to improve the outcome in patients with MODS.

Biopsy ; Child, Preschool ; Clitoris ; pathology ; Disorders of Sex Development ; diagnosis ; pathology ; Female ; Genitalia, Female ; abnormalities ; Humans ; Hypertrophy ; Magnetic Resonance Imaging ; Neurofibromatoses ; diagnosis ; pathology ; Vulvar Neoplasms ; diagnosis ; pathology

0.05). The relative bioavailability of tested capsules to reference tablets was (99.3?13.1)% Conclusion Both formulations are of bioequivalence.

ObjectiveTo investigate the prevalence and distribution characteristics of dental fluorosis of children aged 8 - 12 in Wushan and Fengjie counties of Chongqing and to provide a scientific basis for prevention and control of the disease.MethodsTwenty townships(towns) in Fengjie county and 18 in Wushan county were selected as survey points by random cluster sampling in 2010.Dental fluorosis of all the children aged 8 - 12 was examined with Dean index.The detection rate of children's dental fluorosis,defect rate and dental fluorosis index were compared between the two counties.Results Totally 38 209 children aged 8 - 12 were investigated.The total detection rate of dental fluorosis was 43.09％( 16 466/38 209) in the two counties.The detection rates of dental fluorosis in Wushan and Fengjie were 48.98％ (9397/19 186)and 37.16％(7069/19 023),respectively,and the difference was statistically significant(x2 =544.03,P ＜ 0.01 ).Total detection rates of dental fluorosis of the five age groups(8,9,10,11,and 12-year-old age groups) were 32.52％(2157/6632),40.07％(2672/6668),43.67％(3420/7831 ),46.01％ (3861/8391) and 50.14％ (4356/8687),respectively,and the difference was statistically significant (x2 =510.50,P ＜ 0.01),Dental fluorosis indexes in Wushan and Fengjie were 0.713 and 0.485,respectively.Defect rates of dental fluorosis in Wushan and Fengjie were 4.05％ (777/19 186) and 1.57％(298/19 023),respectively.Conclusions The total detection rate of dental fluorosis of the two counties is still high,which gradually increases with age.Wushan is still an endemic area of dental fluorosis,and Fengjie is at the edge of the

To systematically evaluate the clinical efficacy and safety of compound Danshen injection in treating hypoxic-ischemic encephalopathy (HIE) of newborns. Computer retrievals were made in PubMed, Embase, Cochrane Library, CBM, CNKI, VIP and China info (before May 2014) and relevant literature references, and manual retrievals were made for journals and conference papers, in order to collect randomized or semi-randomized controlled trials concerning compound Danshen injection in the treatment of neonatal HIE. The quality of included references was evaluated according to literatures recommended by Cochrane Handbook. RevMan 5. 3 software was applied in the statistical treatment. Finally, a total of 13 randomized controlled trials were included, covering 1,211 patients (including 639 patients in the compound Danshen injection-treated group and 572 patients in the control group). Meta-analysis results showed that the routine treatment combined with compound Danshen injection can improve the treatment efficiency of neonatal HIE [RR = 1.28; 95% CI (1.21-1.36)], reduce the mortality rate [RR = 0.42; 95% CI (0.23-0.75)] and the incidence of long-term neurological sequelae [RR = 0.48; 95% CI (0.35-0.65)], with statistical differences. No fatal side effect was observed in all of included trials. So far, limited evidences in this study proved that the application of compound Danshen injection in the treatment of neonatal HIE can enhance the clinical efficiency. However, because of the low quality of the included trials, more well-designed and large-scale multi-center randomized controlled trials shall be made in the future.
Drugs, Chinese Herbal ; administration & dosage ; Humans ; Hypoxia-Ischemia, Brain ; drug therapy ; Infant, Newborn ; Infant, Newborn, Diseases ; drug therapy ; Injections ; Randomized Controlled Trials as Topic

Objective To evaluate the diagnostic performance of a point-of-care testing for sensitive cardiac troponin Ⅰ (POCT-cTnI) in early diagnosis of chest pain patients who had a high pretest probability of acute myocardial infarction (AMI).Methods Total of 127 patients with new-onset chest pain at the emergency department were enrolled.Blood samples were drawn for the routine blood test,and determined POCT-cTnI and central laboratory testing for high sensitive cardiac troponin T (CLT-hscTnT) at admission,three and then at six hours after admission.All patients were divided into AMI group and non-AMI group according to the final diagnosis,which was adjudicated independently by two physicians who reviewed all available medical records for the 90-day follow-up period,and they were unaware of the results of the investigational assays of cardiac troponins.The receiver operating characteristic (ROC) curves were constructed to assess and compare the diagnostic performance of AMI of two cardiac troponin assays.The comparison of areas under the ROC curves (AUC) was performed by DeLong test,and the sensitivity,specificity,negative predictive values (NPV) and positive predictive values (PPV) for the target markers were calculated by applying a maker-specific cutoff value.Results The final diagnosis of AMI was made in 40 of 127 patients (31.5 ％).The diagnostic accuracy of the two assays oBtained at presentation,as quantified by AUC,was no statistically differences (AUC for POCT-cTnⅠ,0.901,95％ CI,0.901 to 0.947;and for CLT-hscTnT,0.907,95％ CI,0.842 to 0.951;Z =0.235,P =0.745).The AUC for POCT-cTnI at 3 hours after admission was significantly higher than that on admission (0.931 vs.0.858;Z =-2.038,P =0.042),while there was on further improvement at 6 hours after admission (0.931 vs.0.949;Z =-1.435,P =0.151).With use of POCT-cTnI (cutoff value 0.023 ng/mL,which was the 99th percentile upper reference limit) on adimission,the clinical sensitivity was 77.5％,and the specificity was 94.2％.A single sample of POCT-cTnI at 3 hours after admission improved the diagnostic accuracy,with a sensitivity of 96.4％,a specificity of 92.0％,and a NPV of 98.6％,a PPV of 81.8％.While,with use of CLT-hscTnT (cutoff value 0.014 ng/mL,was the 99th percentile upper reference limit) at 3 hours after admission,the NPV reached to 100％.Conclusions The use of a POCT-cTnI assay in chest pain patients can identify and exclude the AMI rapidly and exactly at three hours after admission,and the diagnostic performance is equivalent to CLT-hscTnT.

ObjectiveTo investigate the clinical characteristics of the inpatients suffering from dengue fever in order to provide references for better diagnosis and treatment.Methods The clinical data of 158 dengue fever patients admitted to the First Affiliated Hospital of Sun Yat-Sen University from July 23rd to October 31st, 2014 during the 2014 epidemic in Guangzhou area were retrospectively analyzed, including general clinical manifestations, conventional examinations, pathogenesis, and prognosis.Results The mean age of the 158 patients was (56±20) years, with half of them over 60 years old (79 cases). Among them, 94 (59.49%) were male.① The common manifestations included fever (100%), headache (70.89%), myalgia/bone soreness (62.03%), and skin rash (54.43%). Bleeding and plasma leakage were found in 25.95% and 14.56% of the patients respectively.② Laboratory examination:leucopenia (75.32%) and thrombocytopenia (77.85%) were found, and alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were elevated in 57.59% and 77.85% of the patients respectively. However, elevation of blood hematocrit was rare (1.27%).③ It was found that in the acute phase (0 - 5 days of the onset), serum dengue virus antibody IgM (DF-IgM) was positive in 63.54% of the patients (61/96), and 92.62% (113/122) of patients were dengue virus RNA (DENA-RNA) positive.④ The rate of comorbidity in this study was 55.06% (87/158), including hypertension (27.22%) and type 2 diabetes (15.82%), which were the two most common co-morbidities.⑤ All the patients were given supportive therapy to prevent complications. They were also isolated for more than 5 days after onset, and at least for 24 hours after subsidence of fever in addition.⑥ The criteria for the diagnosis of severe dengue were fulfilled in 18 patients (11.39%). One patient died of massive hemorrhage from gastro-intestinal tract, and 1 patient voluntarily left hospital with untreated multiple organ dysfunction syndrome (MODS). Another 2 patients of dengue fever died from primary cardio-cerebrovascular disease, and the remaining 154 patients (97.47%) fully recovered with supportive therapy and complication prevention measures.Conclusions The clinical manifestations of inpatients with dengue fever in this study were typical, and they manifested a higher incidence of severe illness. DENA-RNA could be a sensitive indicator for early pathogenic diagnosis. With symptomatic and supportive therapy, most patients had a good outcome. However, early diagnosis and clinical interventions of severe dengue still need further studies.

Objective To compare the effects of transforaminal peripheral nerve stimulation(PNS) and spinal cord stimulation(SCS) in treatment of postherpetic neuralgia.Methods A total of 64 patients with postherpetic neuralgia in our hospital from January 2015 to January 2016 were divided into PNS group and SCS group according to random number table.Both two groups were treated with PNS or SCS for 14 days,respectively.Visual analogue scale(VAS) and piasburgh sleep quality index(PSQI) were adapted to assess the effects at the different time of preoperation, postoperation 1 day,1 week,1 month,2 months.Results At the preoperation and 2 months postoperation,in PNS group,the VAS were (8.4±1.6) and (1.4±1.0),the PSQI were (16.1±2.1) and (5.8±1.3),respectively;meanwhile in the SCS group,the VAS were (8.6±1.8) and (2.9±1.2),the PSQI were (15.6±2.3),(7.5±1.5),respectively.Obviously,the VAS and PQSI at different follow-up stages were improved after transforaminal PNS or SCS treatment, the differences were signicant(P<0.05).Moreover,the PNS group had lower VAS and higher PQSI compared with the SCS group at different follow-up stages,the differences were signicant(P<0.05).Conclusion The transforaminal PNS achieved satisfying outcomes on pain relief and quality of sleep improvements for the postherpetic neuralgia patients,which was superior to that of the SCS.