Objective To investigate the safety,therapy and prophylactic effect of Omeprazole on stress ulcer in children with epidemic type B encephalitis.Methods Before and after medication,chest X-ray examination was performed.The result of occult blood(OB) was confirm by Colloidal gold assay in stool and/or gastric juice.Based on the result of OB,the patients were divided into therapy group[besides conventional therapy for encephalitis,Cimitidine group and Omeprazole group with positive result OB,was administered with 0.9% normal sodium 100 mL+Cimitidine 20-40 mg/(kg?d),iv,q12 h and normal sodium 100 mL+Omeprazol 0.5-0.8 mg/(kg?d),iv,qd,respectively] and prophylaxis group(Cimitidine group,Omeprazole group and control group,with negative result OB,were administered with same medicines as therapy group,respectively.Except control group being administered only 0.9%NS 100 mL,iv,(q12 h)).The effects of drugs on hemostasis,preventing hemorrhage,and the potential risk of acquired pneumonia result from drugs used were observed.Results In therapy group,the average time of hemostasis in Omeprazole group was obviously shorter than that of in Cimitidine group,there was significant difference between two groups(P0.05).Conclusions Both of the drugs is safety and effect to therapy or prophylaxis for the latent stress ulcer in short term.The effect of Omeprazole is better than those of Cimitidine.Using Cimitidine and Omeprazole,neither therapy nor prophylaxis for stress ulcer increaseds the potential risk of acquired pneumonia in children with epidemic type B encephalitis in this study.

ObjectiveTo observe the effect and side effect of intravascular He-Ne laser irradiation (ILIB) on the abnormal lipid metabolism induced by clozapine.Methods52 patients with schizophrenia (34 males, 18 females) took clozapine alone at a dosage of 200-350 mg/d. All patients were treated with ILIB every other day, 60 min once, ten times altogether. Before and after treatment, lipid metabolism, liver, kidney and blood coagulate functions of patients were tested.ResultsTC, TG, LDL-ch levels of patients decreased obviously after ILIB treatment (P<0.05), while HDL-ch level increased obviously (P<0.01). The liver, kidney and blood coagulate functions were as same as before treatment.ConclusionILIB has an extreme effect on the abnormal lipid metabolism induced by clozapine, and it is quite safe and has clinical practice value.

ObjectiveTo explore the effect of music treatment on memory decrease causing by clozapine of patients with schizophrenia. MethodsThe 70 patients with schizophrenia aged 18 to 30, who were in hospital for the first time and had graduated from middle school were divided into the experimental group who received music treatment and the control group with 35 cases each at random,when they reached the clinical cure standard after only taking clozapine. The two groups were given the same test before and after the experiment.ResultsThe memory measurement of the two groups had no difference before the experiment(P>0.05). The patients in the experimental group greatly increased their memory after the treatment (P<0.01), but these was no significent difference in the control group (P>0.05).Conclusions Music treatment can help to improve the memory of the patients received clozapinetreatment.

Objective To investigate the clinical effect of dysmenorrhea in patients with adenomyosis treated by high intensity focused ultrasound (HIFU) ablation combined with gonadotropin-releasing hormone agonist (GnRH-a) and levonorgestrel-releasing intrauterine system (LNG-IUS). Methods From April 2012 to December 2015, 477 cases of adenomyosis patients with dysmenorrhea were treated by HIFU in the Third Xiangya Hospital. Among them, some patients were treated with HIFU alone, some of them were treated with HIFU combined with GnRH-a and (or) LNG-IUS, thus were classified as H group, H+G group, H+M group and H+G+M group. The improvements of clinical results were compared among the four groups and the influencing factors of HIFU treatment for adenomyosis were also analyzed. Results During the follow-up period, the overall effective rates of the treatment decreased with time, 3 months 89.4% (345/386), 12 months 84.0%(221/263), 24 months 74.2%(98/132), and the overall recurrence rate was 12.9%(39/303). The significant difference in the curative at 3 months [H group 83.7%(170/203), H+M group 95.0%(95/100), H+G group 100.0%(43/43), H+G+M group 96.8%(30/31)], 12 months [H group 79.4%(123/155), H+M group 93.2%(69/74), H+G group 11/12, H+G+M group 15/17], and 24 months [H group 68.0%(51/75), H+M group 96.4% (27/28), H+G group 6/12, H+G+M group 15/15] after HIFU treatment and recurrence rate [H group 19.0%(29/153), H+M group 3.3%(3/90), H+G group 19.4%(6/31), H+G+M group 4.5%(1/22)] were observed among the four groups (P<0.05). Pairwise comparison further showed that, in 3 months after the treatment, the effect of H group was significantly lower than those of H+M group and H+G group (P=0.003, P=0.005);in 12 months after the treatment, the effect of H group was significantly lower than that of H+M group (P=0.006);while in 24 months after treatment, the effect of H group was significantly lower than that of H+G+M group (P=0.005), and the effect of H+G group was lower than that of H+G+M group (P=0.001); and the recurrence rate of H group was significantly higher than that of H+M group (P<0.008). In patients of group H, the effect of HIFU was related to uterine size, the effect of patients with large uterine volume was significantly higher than that of small volume of uterine of patients (P=0.017, OR=2.739, 95%CI:1.200-6.251); with increasing of age, the improvement of dysmenorrhea had a increasing trend (P<0.05). Conclusions HIFU combined with GnRH-a and (or) LNG-IUS could improve the treatment effect in relief of dysmenorrhea. Based on our results, individual treatment protocol should be selected for different patients.

Objective To explore the risk factors of the recurrence of ischemic stroke and to supply theoretical basis for secondary prevention.Methods 612 patients with ischemic stroke were enrolled in the study and they were followed-up for 2 years to record the stroke recurrence.According to whether the recurrent stroke occurred,all the patients were divided into the recurrent group and the non-recurrent group.Logistic regression model was used to analyze the risk factors.Results Of 612 patients,90 patients suffered from recurrent stroke and the recurrence rate after 2 years was 14.7％.In the recurrent group,age,smoking,hypertension,diabetes,fibrillation atrial history and homocysteine level were significantly higher than those in non-recurrent group (P ＜ 0.05),compliance of anti-platelet drugs was significantly lower than that in non-recurrent group (P ＜ 0.01).Multivariate analysis suggested that age,smoking,hypertension,diabetes,atrial fibrillation history,homocysteine level and compliance of anti-platelet drugs were associated with recurrence of ischemic stroke (OR value =11.14,47.38,53.11,111.12,53.11,40.98,90.12,all P ＜ 0.05).Conclusion Age,smoking,hypertension,diabetes,atrial fibrillation history,homocysteine level and compliance of anti-platelet drugs are the independent risk factors of recurrent stroke.To enhance the interference of these risk factors are helpful for preventing the recurrence of stroke.

Objective To investigate the relationship between the quantified electroencephalograph (EEG) and end-tidal desflurane concentration and characteristics of desflurane absorption during low-flow desflurane anesthesia. Methods Fifteen ASA I - Ⅱ patients with a mean age of (51.6?11.9)yr, weighing (59.6?7.9)kg scheduled for operation performed under combined general and epidural anesthesia were studied. The patients were premedicated with phenobarbital 0.1g and atropine 0.5mg.Epidural catheter was placed and a test dose of 1.0% lidocaine and 0.2% tetracaine was given before induction of general anesthesia. General anesthesia was induced with fentanyl 2-3?g?kg-1, thiopental 4-7mg?kg-1 and succinyl choline 1.5-2.0 mg?kg-1 and maintained with desflurane, intermittent iv boluses of vecuronium and epidural anesthesia. Desflurane anesthesia was started with high-flow for 15min followed by low flow. During high-flow wash-in, FGF was 4L/min, VT was set at 8-10ml?kg-1, PETCO2 was maintained at 4.2-4.6kPa(32-35mm Hg) and desflurane vaporizer was set at 5% .During low-flow FGF 0.5L/min. End-tidal desflurane concentration(Fa) and inspired desflurane concentration (Fi), BIS, SEF90 were recorded at 3,9, 12 and 15min during high-flow wash-in and at 3%, 4.5% and 6% Fa during low-flow. Each Fa was maintained for at least 15min.Results Before induction of anesthesia BIS was 86.0?8.3, SEF95 20.2? 1.8 and SEF90 18.0 ? 2.3 and at the end of 15min high-flow induction they were reduced to 50.4 ? 5.4 (BIS),13.0?1.6(SEF95) and 12.2?1.1(SEF90).The differences were statistically different (P

OBJECTIVETo compare the efficacy between elongated needle therapy and regular needle therapy at Tiantu (CV 22) on the basis of xingnao kaiqiao (activiting brain and regaining consciousness) acupuncture therapy so as to explore the effective therapeutic method in treatment of dysphagia induced by bulbar palsy.

METHODSSeventy one cases of dysphagia induced by bulbar palsy were randomized into two groups. The xingnao kaiqiao acupuncture therapy was applied at Shuigou (GV 26), Neiguan (PC 6), Sanyinjiao (SP 6) and the others in the two groups. In the elongated needle therapy group, on the basis of xingnao kaiqiao acupuncture therapy, the elongated needle was used to puncture Tiantu (CV 22). In the regular needle therapy, the regular acupuncture technique was used at Tiantu (CV 22). In both groups, the treatment was given once a day in a week except Sunday and lasted for 4 weeks totally. Before and after treatment, the swallowing condition and the standardized swallowing assessment (SSA) were observed in the patients and the efficacy was compared between the two groups.

RESULTSThe total effective rate was 97.2% (35/36) in the elongated needle therapy group, which was better than 77.1% (27/35) in the regular needle therapy group (P<0.05). After treatment, SSA score was reduced significantly as compared with that before treatment in the two groups (both P<0.05). SSA score in the elongated needle therapy group was reduced much more apparently as compared with that in the regular needle therapy group after treatment (P<0.05).

CONCLUSIONOn the basis of the xingnao kaiqiao acupuncture therapy, the elongated needle therapy at Tiantu (CV 22) achieves the superior effect on bulbar palsy-induced dysphagia as compared with the regular acu- puncture at Tiantu (CV 22).

Acupuncture Points ; Acupuncture Therapy ; Aged ; Bulbar Palsy, Progressive ; complications ; Deglutition Disorders ; etiology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Treatment Outcome

0.05);the lung′s rale improvement was significant(diffe-)rent(?~2=4.75 P

Objective To study the interobserver variabilities and the differential diagnosis value of Breast Imaging Reporting and Data System-Ultrasound (BI-RADS-US) lexicon for small ( ≤ 2 cm) breast nodules. Methods Between January 2009 and December 2011, 289 patients with small (≤2 cm) breast nodules (n=317) were included. According to sizes, the lesions were divided into two groups, i.e., 0-1 cm (n=160) group and 1-2 cm (n=157)group. Each lesion was described independently by 3 radiologists using BI-RADS-US lexicon. Interobserver variabilities were assessed by Kappa test. Chi-square test was used to compare the frequency difference of the descriptors between malignant and benign lesions. Sensitivity, speciifcity, accuracy, positive predictive value and negtive predictive value were calculated. Results (1)Moderate agreements were obtained for lesion shape, orientation, margin, echo pattern, surrounding tissue and calciifcations (κ=0.44, 0.57, 0.48, 0.43, 0.51 and 0.57) in 0-1 cm group. Substantial agreements were obtained for lesion shape, orientation, margin and echo pattern (κ=0.65, 0.61, 0.64 and 0.63) in 1-2 cm group. (2)Irregular shape, non-parallel orientation, non-circumscribed margin, echogenic halo and microcalciifcations were more frequently found in malignant nodules than in benign nodules in 0-1 cm group [52.3% (34/65) vs 20.0% (19/95), 38.5%(25/65) vs 13.7%(13/95), 75.4%(49/65) vs 32.6%(31/95), 18.6%(12/65) vs 0 (0/95) and 10.8%(7/65) vs 2.1%(2/95);χ2=18.19, 13.08, 28.22, 16.39 and 3.95;P=0.000, 0.000, 0.000, 0.000 and 0.047]. Similarly, irregular shape, non-parallel orientation, non-circumscribed margin, echogenic halo, shadowing, changes of Cooper′s ligament and microcalciifcations were signiifcantly more frequent found in malignant nodules than in benign nodules in 1-2 cm group [74.2%(49/66) vs 12.1%(11/91), 36.3%(24/66) vs 5.5%(5/91), 93.9%(62/66) vs 22.0%(20/91), 37.9%(25/66) vs 3.3%(3/91), 30.3%(20/66) vs 7.7%(7/91), 15.2%(10/66) vs 0 (0/91) and 16.7%(11/66) vs 4.4%(4/91);χ2=62.59, 24.21, 79.40, 31.22, 13.73, 12.30 and 6.67;P=0.000, 0.000, 0.000, 0.000, 0.000, 0.000 and 0.010]. (3)In both groups, a good sensitivity was demonstrated (75.4%&93.9%) when using the non-circumscribed margin as a criterion for malignancy, and high speciifcity was achieved in two groups (80.0%-100%and 87.9%-100%) when other descriptors including irregular shape, non-parallel orientation, echogenic halo, shadowing, changes of Cooper′s ligament and microcalciifcations were used as differentiation criteria. Conclusions Good interobserver agreement can be achieved using the BI-RADS-US lexicon in the diagnosis of small breast nodules. Non-circumscribed margin are proved as the most valuable sign for screening malignant breast lesions ≤ 2 cm. High speciifcity was found for irregular shape, nonparallel orientation, echogenic halo, shadowing, Cooper′s ligament changes and microcalciifcations, which can help biopsy and preoperative diagnosis.

Bacteremia ; etiology ; Female ; Humans ; Infant, Newborn ; Listeria monocytogenes ; isolation & purification ; Male