Objective To evaluate the short-term efficacy and safety of combination therapy with amlodipine and terazosin in middle aged and old male patients with essential hypertension.Methods Randomized,prospective,parallel study was carried out in middle aged and old male patients with essential hypertension in Anqing community between August 2005 and February 2006.Antihypertensive efficacy and safety of the combination therapy were evaluated in 508 patient who completed the study.Results After 4 weeks treatment,the average reduction of SBP were 4.0?15.0,17.5?15.8 and 20.0?15.9 mm Hg in Terazosin group,amlodipine group and combination group,respectively(P

Objective:The drug resistance of E.coli to fluoroquinolones is getting stronger in the recent years.This study aimed at the drug resistance of E.coli induced by fluoroquinolones in vitro,so as to provide a guidance for the rational use of antibiotics and effective control of nosocomial infections.Methods: Drug resistance was induced in vitro by a multi-step method in 10 strains of E.coli from clinical isolates with Ciprofloxacin,Levofloxacin and Gatifloxacin.The minimal inhibition concentration(MIC) of the E.coli was determined by the agar dilution method before and after the induction.Results: After in vitro induction,the E.coli acquired a high resistance(MIC ≥ 128 ?g/ml).And one drug could induce different degrees of resistance to the other two.Conclusion: The MIC of the E.coli induced by fluoroquinolones in vitro was increased by 8 to 8 205 folds compared with that before induction,which demonstrated a gradually developed resistance of E.coli strains to fluoroquinolones.

Female ; Humans ; Hyperthyroidism ; drug therapy ; etiology ; Infant, Newborn ; Male

Objective To elucidate the relationship between Child-Pugh grading and the degree of hep- atic cirrhosis.Method Six patients each with hepatic cirrhosis in Child-Pugh grade A and B were selected.The livers were observed with gross examinations during operation,and the liver specimens were observed with gross ex- aminations and also checked with light and electron microscopies.Results With naked eyes,it was quite difficult to find differences in size,shape and between different Child-Pugh grades.With hght microscopy,hepatic fibrosis of Ⅰ-Ⅱ degrees was commomly seen in Child-Pugh grade A and necrosis of hepatic cells was slight,while fibrosis of Ⅲ-Ⅴ degrees was usually found in grade B and necrosis was severe.With electron microscopy the collagen fib- rils in Disse's spaces were white cloud-like in grade A,while they were band-like in grade B.Of swelling and de- generation of organellae of hepatic and Kupffer cells,they were worse in grade B than in grade A.Conclusion The parameters in Child-Pugh grading are not complex,but they can be used to evaluate the degree of lesions. There is a positive relationship between them.

OBJECTIVE:To observe the clinical efficacy and safety of Qingkailing injection combined with naloxone in the ad-juvant treatment of chronic obstructive pulmonary disease (COPD) with pulmonary encephalopathy. METHODS:80 COPD pa-tients with pulmonary encephalopathy were randomly divided into control group and observation group. Control group was treated with conventional treatment,including bi-level noninvasive positive pressure ventilation,conventional oxygen inhalation,anti-infec-tion,resolving sputum and relieving asthma,etc;based on the treatment of control group,observation group was additionally treat-ed with Qingkailing injection 40-60 ml by intravenous infusion,30-40 drops/min,qd+Naloxone hydrochloride injection 0.8 mg by intravenous infusion,and then Naloxone hydrochloride injection 2 mg by microinfusion pump for continuous 24 h. After 3 d,the clinic data was observed,including clinical efficacy,and pO2,pCO2,pH,CO,CI,GCS coma score before and after treatment,av-erage hospitalization time,endotracheal intubation rate and incidence of adverse reactions. RESULTS:The total effective rate in ob-servation group was significantly higher than control group,average hospitalization time and incidence of adverse reactions were significantly lower than control group(P<0.05). After treatment,pO2,pH and GCS scores in 2 groups were significantly higher than before,observation group was higher than control group,pCO2 was significantly lower than before,observation group was lower than control group(P<0.05). There were no significant differences in the CO and CI before and after treatment and endotra-cheal intubation rate between 2 groups (P>0.05). CONCLUSIONS:Based on the conventional treatment,Qingkailing injection combined with naloxone has good efficacy and safety in the adjuvant treatment of COPD with pulmonary encephalopathy.

Objective To determine the diagnostic value of diffusion weighted imaging(DWI) for primary nasopharyngeal carcinoma(NPC) and metastatic lymph nodes,and to establish the diagnostic thresh-old of apparent diffusion coefficients(ADCs). Methods Conventional MR scans and DWI scans were con-tinuously performed in 56 patients with newly diagnosed NPC and 55 healthy volunteers. All patients re-ceived primary tumor biopsy and MR image-guided cervical lymph node fine-needle biopsy. ADC and eADC values of both primary lesions and lymph nodes were calculated and compared. Results According to the pathological diagnosis,all the 56 patients had non-keratinizing carcinoma and 51 had lymph node metastasis. In the control group,75 cervical lymph nodes were found. ADC values of both primary NPC and metastatic lymph nodes were significantly lower, while eADC values were higher than those of normal controls. Setting the ADC value threshold at 0.809 ×10-3 mm2/s, the sensitivity and specificity for primary NPC detection were 80.4% and 74.5%, respectively. The negative and positive predictive values were 79.2% and 77.6% ,respectively. The accuracy was 78.4%. Setting the ADC value threshold at 0. 708×10-3 mm2/s, the sensitivity and specificity in the detection of metastatic cervical lymph nodes were 43.1% and 93.3%, respectively. The negative and positive predictive values were 70.7% and 81.5% ,respectively. The accura-cy was 73.0%. Conclusions DWI might be a new diagnostic approach in the detection of primary NPC as well as metastatic lymph nodes.

r governments and mescal institutions in their prevention and control.

Purpose To investigate the diagnostic value of fetal echocardiography in total anomalous pulmonary venous connection (TAPVC),and to analyze the reasons ofmisdiagnosis so as to improve accuracy of prenatal diagnosis.Materials and Methods The prenatal echocardiographic data of 24 cases of TAPVC confirmed by postnatal echocardiography and prenatal MRI from October 2001 to December 2015 in Children's Hospital Affiliated to Nanjing Medical University and Shanghai Children's Medical Center Affiliated to Shanghai Jiaotong University School of Medicine were retrospectively analyzed.Results In 24 cases,there were 14 fetuses of supracardiac type,7 cases of intracardiac type,2 cases of infracardiac type,and 1 case of mixed type.15 fetuses had TAPVC only,whereas 9 cases were associated with other cardiovascular anomalies,most commonly including bilateral right atria,single atrium,single ventricle,common atrioventricular valve and pulmonary stenosis.On 4-chamber views,the common sonographic sign was absent of pulmonary venous return to the left atrium in 24 cases (100.0％),and the presence of venous confluence between left atrium and descending aorta was observed in 22 cases (91.7％).In all 24 cases,1 case was missed diagnosis,and 3 cases were misdiagnosed as persistent left superior vena cava,common pulmonary vein atresia and patent left atrial cardinal vein.Conclusion TAPVC can be accurately diagnosed by fetal echocardiography,but it is prone to be misdiagnosed.

OBJECTIVE To analyze resistance and detect plasmid-mediated AmpC genes in Klebsiella pneumoniae.METHODS The susceptibility of the K.pneumoniae to 13 antibiotics was tested by K-B method.Modified three-dimensional extract test was adopted to detect AmpC lactamases in K.pneumoniae.The genotypes of AmpC lactamases were determined by polymerase chain reaction and sequencing.RESULTS Among the 105 isolates,the rate of extended spectrum ?-lactamases(ESBLs) was 41.90%,the rate of AmpC ?-lactamases was 0.95% strains,and the rate of ESBLs and AmpC ?-lactamases was 2.86%.DNA sequence analysis conformed that AmpC lactamases positive isolates were DHA AmpC gene.The resistance rate to penicillins,cephalosporins,?-lactam/?-lactam inhibitors,monobactams,and fluoroquinolones was very high.The susceptibility rate to imipenem was 100.00%.CONCLUSIONS The plasmid-mediated AmpC gene is present in clinically isolated K.pneumoniae.The resistance can be transferred to homologous or different genera of bacteria.

Acute Lung Injury ; etiology ; surgery ; Burns, Inhalation ; surgery ; Humans ; Lung Transplantation ; Male ; Middle Aged ; Respiratory Aspiration ; complications ; Sulfuric Acids ; poisoning