Objective To study the effects of new triple therapy with clarithromycin plus amoxicillin and omeperazole combined into 3 therapeutic therapies, and 3 therapeutic courses to treat children with helicobacter pyloric(Hp) infection.Methods Two hundred and four patients who were diagnosed by gastroscopy as Hp-related gastroentestinal diseases and divided into 3 groups,randomly.Group A was treated with amoxicillin 50 mg/(kg?d)+bismuth citrate 7-8 mg/(kg?d)+metronidzole 15-20 mg/(kg?d) for six weeks;group B took the same drugs but for two weeks;group C was treated with clarithromycin 15 mg/(kg?d)+omeperazole 0.8 mg/(kg?d)+amoxicillin 50 mg/(kg?d) for 2 weeks.Results The rates of eradicate of Hp:group A 73.4%,group B 75%,group C 92%.The differences between group B and group C were very significant.Conclusion Triple therapy is more effective, less duration,well tolerated, less resistant,with higher rate of eradication.

Objective To analyze and compare the clinical application values of procalcitonin (PCT),leukocyte count (WBC) and C-reactive protein(CRP) in elder patients with infection.Methods In patients(age≥ 65 yrs,axillary temperature ＞38.0℃)with infection or suspected infection,PCT,WBC,CRP and other bacteriological examination were performed.The electronic medical records from the HIS system of our hospital were analyzed retrospectively in combination with medical history.Results Of the enrolled 219 patients,65 ones were in control group,48 ones SIRS,51 ones sepsis and 55 ones MODS.There was a positive correlation between the level of serum PCT and the infection degree.The Spearman correlation coefficient was 0.706 (95％CI:0.616-0.797,P=0.000).Based on the highest Youden index (sensitivity+specificity-1),the best cutoff point of diagnosis for PCT was ＞0.341 μg/L (sensitivity 84.5％,specificity 55.8％),a analysis of receiver operating characteristic(ROC) curve about PCT,WBC and CRP was carried.Area under the curve (AUC) of PCT to controlled infection was 0.916 (95％CI:0.864-0.967,P=0.000).Based on the highest Youden index (sensitivity+ specificity-1),the judging threshold of PCT to infection controlled or not was 0.73 μg/L (sensitivity 84.6％,specificity 88.0％).PCT level after treatment ＞0.73 μg/L showed the uncontrolled infection,＜ 0.73 μg/L controlled.Conclusions PCT has a higher specificity for elder patients with infection.The variation of PCT level can guide the application of antibiotics,avoid abuse and decrease the occurrence of drug-resistant bacteria.

Objective To evaluate the effects of sirolimus on scopolamine-induced cognitive dysfunction in rats.Methods Thirty male Wistar rats,aged 3 months,weighing 200-250 g,were equally randomized into 3 groups:normal saline group (NS group),scopolamine group (SC group) and scopolamine + sirolimus group (SS group).Normal saline,scopolamine 0.8 mg/kg and sirolimus 3.5 mg/kg + scopolamine 0.8 mg/kg were injected intraperitoneally in groups NS,SC and SS,respectively,and the injection was continued for 14 consecutive days.The cognitive function was assessed by Morris water maze test on 15th day.After behavior test,the rats were sacrificed and the prefrontal cortex and hippocampus were harvested for determination of amyloid β protein (Aβ) and Tau protein expression.Results Compared with NS group,the escape latency was significantly prolonged,the ratio of time spent in the target quadrant was decreased,Aβ expression in prefrontal cortex and hippocampus was upregulated and Tau protein expression in prefrontal cortex and hippocampus was down-regulated in group SC (P ＜0.05 or 0.01).Compared with SC group,the escape latency was significantly shortened,the ratio of time spent in the target quadrant was increased,Aβ expression in prefrontal cortex and hippocampus was down-regulated and Tau protein expression in prefrontal cortex and hippocampus was up-regulated in group SS (P ＜ 0.05 or 0.01).Conclusion Sirolimus can significantly improve scopolamine-induced cognitive dysfunction in rats and the changes in the expression of Aβ and Tau protein in prefrontal cortex and hippocampus may be involved in the mechanism.

Objective To investigate the expression of cyclin kinase inhibitor P21~(WAF1) and P27~(KIP1)in children with acute leukemia and its clinical significance.Methods A total of 32 hospitalized children with acute leukemia(AL) were included in this study.Their bone marrow samples were collected before chemotherapy and individual patient was detected after complete remission(CR).The method of immunocytochemistry was used to estimate the expression of P21~(WAF1) and P27~(KIP1).Both positive percentage and intensity of the cells were counted.Results Findings showed that the positive ratios of P21~(WAF1) and P27~(KIP1) in total samples,ALL samples and AML samples were lower than the control group(P

Objective To investigate clinical characteristics of relapsing polychondritis(RP)and to improve early recognition for it.Methods Clinical and laboratory data of 56 patients with RP were analyzed retrospectively.Results Ratio of number of male patients to female ones was 1.2.Age at onset was(46?11)years(ranging from 27 to 71)and average interval between onset and diagnosis was(21? 35)months,(8?6),(16?31)and(29?37)months for patients initial onset with auricle,respiratory tract and joints involved,respectively.Site involved included airway in 40 patients(71.4%),auricle in 32 (57.1%),joints in 32(57.1%),eyes in 27(48.2%),nasal chondritis in 25(44.6%)and inner ear in 13(23.2%).At initial stage of the course,17 patients were misdiagnosed as respiratory infection (30.4%),nine as perichondritis(16.1%),six as pulmonary tuberculosis(10.7%),five as rheumatoid arthritis(8.9%).Seven of 40 patients with airway involvement received metallic stents for their tracheobronchial stenosis.Four patients whose condition never improved after regular therapy all had respiratory involvement.Conclusions Patients of RP with initial onset at non-auricle,non-nasal sites tended to be misdiagnosed.Prevalence of airway involvement was not so low with a poor prognosis in patients of RP.

The internship is the transition period of a medico becoming a doctor,the cultivation of clinical work ability of interns is a comprehensive ability cultivation which includes the foundation theories' consolidation and use,the practical operative train- ing,the cultivation of clinical thought ability and communication between doctors and patients,etc.To educate pediatrics intern has its characteristics.

Abstract: Objective To analyze a case of bloodstream infection caused by Ureaplasma urealyticum after abortion in Anxi County Hospital, so as to provide basis for the clinical diagnosis and treatment. Methods　The diagnosis of Ureaplasma urealyticum in this patient with bloodstream infection was retrospectively analyzed. The basic clinical data and laboratory diagnosis data were collected, including the characteristics of blood culture curve, Wright staining of culture medium, drug sensitivity of Mycoplasma liquid identification, colony characteristics of solid medium, and the conclusion of targeted DNA sequencing. Through the comprehensive analysis of the above data, the rapid diagnosis of this case can be realized by optimizing the detection and diagnosis process. Results　The clinical manifestations of this patient were fever of 38.5 ℃, CRP:14.85 mg/L, WBC:14.33×109/L, NET: 85.40%, PCT: 0.12 ng/mL, IL-6: 665.6 pg/mL, positive after 3 days of blood culture, no bacteria were found in Gram stain, and sand-like purple bacteria were observed after adding Wright's stain. After inoculation in blood agar, Mycoplasma solid and liquid medium, no colonies were grown in blood agar, after 48 h and 5 d. On Mycoplasma A7 agar, the edge of brown fried egg colony was striature, and it could be identified as Ureaplasma urealyticum with the Mycoplasma ID & AST panel, which was resistant to quinolones and spectinomycin, but sensitive to macrolides, tetracyclines and lincomycin. Subsequent targeted DNA sequencing results were also confirmed for Ureaplasma urealyticum. Before receiving the report, clinical experience treatment with ceftriaxone metronidazole was used to fight infection with negative bacilli and anaerobic bacteria. Mycoplasma was not treated with targeted treatment. After 3 days, the patient's body temperature returned to normal, inflammation index decreased, and the patient asked to be discharged. Conclusions　At present, there are few reports of bloodstream infection caused by Ureaplasma urealyticum, and the lack of clinical understanding can easily lead to misdiagnosis and missed diagnosis. In order to improve the detection rate of Mycoplasma in blood culture, it is necessary to optimize the detection procedure of blood culture and provide accurate diagnosis and treatment basis for clinical practice. However, it is clear from this case that Mycoplasma bloodstream infection cases are self-limited infection and can recover by themselves without targeted treatment in patients with normal immunity. Therefore, it is very important to protect the immunity of patients.

OBJECTIVETo investigate the effect and mechanism of Shenqi Fuzheng Injection (SFI) in repairing immune function of organism at cellular and molecular levels.

METHODSSeventy-seven patients with pathologically confirmed diagnosis of breast cancer were assigned to three groups, the 22 patients in group A received surgical operation only; the 26 in group B were treated with surgical operation and chemotherapy; and to the 29 in group C, both chemotherapy and SFI were given after surgical operation. Besides, a group D with 22 patients with benign tumor was set up for control. The protein expressions of CD83, CD80 and CD86 in all patients' tumor tissue and axillary lymph node were detected by flow cytometry before and after treatment.

RESULTSLevels of CD83, CD80 and CD86 in both tumor tissue and lymph node of cancer patients were significantly lower than those in the control (P < 0.05); and those in group B were significantly lower than in group A (P < 0.05, P < 0.01); but no significant difference was found in comparing the corresponding indices between group A and group C (P > 0.05).

CONCLUSIONThe immune function of tumor patients could be impaired by tumor and chemotherapy definitely, and SFI could give aid to the repairing of immunity by way of participating in the activation of dendritic cells and the up regulation of co-stimulus molecules.

Adult ; Aged ; Antigens, CD ; metabolism ; B7-1 Antigen ; metabolism ; B7-2 Antigen ; metabolism ; Breast Neoplasms ; drug therapy ; immunology ; surgery ; Carcinoma, Intraductal, Noninfiltrating ; drug therapy ; immunology ; surgery ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Immunity ; drug effects ; Immunoglobulins ; metabolism ; Membrane Glycoproteins ; metabolism ; Middle Aged ; Phytotherapy

OBJECTIVETo evaluate the significance of cardiac output (CO) response against exercise determined by IGR method and LVEF, 6 MWT distance in patients with chronic heart failure (CHF).

METHODTo adopt 6 MWT, and before and after the test measuring the CO by the IGR method, furthermore, measure LVEF to 36 patients (heart failure group) with CHF, compare with the health groups (control group).

RESULTSThe 6MWT distance of heart failure group (333.00 +/- 49.64) m decrease compared with the control group (582.56 +/- 67.97) m (P < 0.01), moreover, the distance of NYHA class III (314.82 +/- 36.27) m is significantly shorter than II (361.57 +/- 55.42) m (P < 0.05). The LVEF of heart failure group (47.0 +/- 0.4)% reduce compared with the control group (66.9 +/- 5.2)% (P < 0.01), and the data of NYHA class III (43.3 +/- 10.3)% is significantly lower than II (52.8 +/- 7.6)% (P < 0.01). The increase in CO response against exercise of heart failure group (5.97 +/- 1.89) L/min decrease compared with control group (8.88 +/- 0.52) L/min (P < 0.01), furthermore, the value of NYHA class III (5.31 +/- 1.52) L/min, compared with II (7.01 +/- 1.98)L/min, is obviously lower (P < 0.01). The 6MWT distance correlates positively with the increase in CO response against exercise (r = 0.63, P < 0.01), but the correlation is not found between the increase CO response against exercise and the LVEF (r = 0.11, P > 0.05).

CONCLUSIONOur results show that CO response against exercise measured by IGR method, with the advantages of being noninvasive, safe, convenient and accurate, combining with the 6MWT can evaluate cardiac reserve in patient with CHF.

Adult ; Aged ; Cardiac Output ; Case-Control Studies ; Chronic Disease ; Exercise Test ; Exercise Tolerance ; Female ; Heart Failure ; diagnosis ; physiopathology ; Humans ; Male ; Middle Aged ; Walking

OBJECTIVETo investigate the association between hyperglycemia and outcome in elderly patients with acute ST segment elevation myocardial infarction (STEMI) underwent primary percutaneous coronary intervention (PCI).

METHODSThis retrospective analysis was performed on 284 elderly patients (age > or = 60 years) with acute STEMI underwent primary PCI between January 2000 to April 2004 in our department. Patients were divided into 3 groups according to the level of blood glucose on admission: group A, < 7.8 mmol/L; group B, 7.8 - 10.9 mmol/L; group C, > or = 11.0 mmol/L.

RESULTS(1) The proportion of female in group B and group C was greater than that of group A (33.3% vs. 26.5%, P < 0.01; 40.2% vs. 26.5%, P < 0.01). The hospital stay time of group B and group C was significantly longer than that of group A (16.0 days vs. 13.9 days, P < 0.05; 16.6 days vs. 13.9 days, P < 0.05). There were more patients with history of hypertension in group C than that in group A (72.1% vs. 54.9%, P < 0.01). (2) After PCI, the proportion of patients with TIMI myocardial perfusion grade (TMPG) 0-1 in group B and C was greater than that of group A (22.6% vs. 13.3%, P < 0.05; 34.1% vs. 13.3%, P < 0.05). The proportion of patients with TMPG 3 in group B and C was less than that in group A (74.3% vs. 84.4%, P < 0.05; 57.6% vs. 84.4%, P < 0.05). The complication rate of PCI was significantly higher in group C than in group A (42.5% vs. 20.6%, P < 0.01) and group B (42.5% vs. 26.6%, P < 0.01). IABP use was significantly more in group C than that in group A (19.5% vs. 4.9%, P < 0.01) and group B (19.5% vs. 6.4%, P < 0.01). (3) There were more patients with grade of Killip class > or = 2 in group C than that in group A (44.8% vs. 23.5%, P < 0.01) and group B (44.8% vs. 27.7%, P < 0.01). The in-hospital mortality rate (8.0% vs. 1.1%, P < 0.05) and one-year mortality rate (18.7% vs. 3.4%, P < 0.05) of group C were significantly higher than those in group A.

CONCLUSIONHyperglycemia at admission was associated with poor tissue perfusion, cardiac function and prognosis in elderly patients with acute STEMI underwent primary PCI.

Aged ; Angioplasty, Balloon, Coronary ; Blood Glucose ; analysis ; Female ; Humans ; Hyperglycemia ; Male ; Middle Aged ; Myocardial Infarction ; blood ; physiopathology ; therapy ; Prognosis ; Retrospective Studies ; Treatment Outcome