Antitubercular Agents ; standards ; Child ; Humans ; Tuberculosis ; drug therapy ; prevention & control

Objective:To determine the changes of intramucosal pH(pHi) after severe craniocerebral injuries and the correlation to bleeding from stress ulceration. Methods:Nineteen cases of severe head trauma patients were enrolled, their pHi were determined at different time point with tonometry. The pH of gastric juice and plasma gastrin concentrations were monitored for 7 days. Results:Five cases(bleeding group) developed stress ulcer bleeding. On admission, the pHi were not significantly different in the non bleeding group, but the differences between two groups at 12 hours, 24 hours, the 3rd day, the 5th day, the 7th day after admission were significant, pHi in the bleeding group was statistically lower than non bleeding group. The pH values of gastric juice and the plasma gastrin concentrations were not different significantly between two groups during each therapeutic periods. Conclusion:Bleeding group had significantly lower pHi than non bleeding group during the therapeutic periods. pHi was predictive for bleeding from stress ulceration after severe craniocerebral injury.

ObjectiveTo evaluate the clinical efficacy ofYigongpowder withYupingfengpowder for syndrome of spleen deficiency in children with mycoplasma pneumoniae pneumonia.MethodsA total of 60 patients who had spleen deficiency after azithromycin injection 5 days were randomly divided into treatment group and control group according to the random number table, with 30 in each group. The patients in both received azithromycin suspension for 2 weeks, while the patients in the treatment group received azithromycin suspension and traditional Chinese medicineYigongpowder withYupingfengpowder for 2 weeks. The symptoms score was used to evaluate the clinical efficacy.ResultsThe scores of appetite loss (0.65 ± 1.00vs. 2.32 ± 1.28,t=5.631), abdominal distention (0.73 ± 0.23vs.1.33 ± 0.97,t=3.297) and fatigue (0.72 ± 0.32vs. 1.42 ± 1.18,t=3.136) in the treatment group were significantly lower than those in the control group (all P<0.05). The total effective rate for syndrome of spleen deficiency in the treatment group was significantly higher than thatin the control group(90.0%vs.66.7%;χ2=4.812,P<0.05).ConclusionYigongpowder withYupingfeng powder can significantly improve the symptoms of syndrome of spleen deficiency in children with mycoplasma pneumoniae pneumonia.

Objective To develop a Chinese version of Death Attitude Proevaluate its reliability and validity by applying it in the Chinese Christians.Methods After undergoing forward and backward translation of the DAP-R by expert consultation and in-depth interview,150 Christians over 40 years old were recruited to complete the Chinese version of DAP-R,And then factor analysis,correlation analysis and reliability analysis were applied to establish the scale's construct validity and reliability.Results The final scale consisted of five dimensions with 25 items; the varimax rotation factor analysis of the scale identified seven principal factors and explained for 67.075% variances; the correlation coefficient between each item and its domain was 0.432～0.850; Cronbach's α coefficient of five domains were 0.585～0.853,the Cronbach's α and split-half coefficient for the whole scale were 0.840 and 0.843 respectively.Conclusions The Chinese version of DAP-R possesses acceptable validity and reliability in the setting of Christians,and more in-depth study on the scale needs to be done in a wider population.

Objective To evaluate therapeutic effects of hyperthermia therapy in combination with chemotherapy for the treatment of nonsmall cell lung carcinoma. Methods Fifty-two patients with non-small cell lung carcinoma underwent hyperthermia therapy in combination with chemotherapy(NP regimen) in this hospital between September 2003 and November 2006.The therapeutic effects were evaluated after 3 cycles of the combination therapy,and were compared with those from 16 patients receiving only chemotherapy between January 2006 and November 2006.Results The combination therapy offered significantly better curative short-term effects than the simple chemotherapy.The total response rate was 65.4%(34/52) for the combination therapy and 37.5%(6/16) for the simple chemotherapy(Z=-2.419,P=0.016).Significant pain relief was achieved in patients after the combination therapy,while no analgesic effect was noted after the simple chemotherapy,the difference between the two groups of patients being statistically significant(Z=6.486,P=0.000).There was no significant difference in the incidence of complications between the two groups,which mainly included nausea,granulocytopenia,thrombocytopenia,and abnormal liver functions.Conclusions Hyperthermia therapy in combination with chemotherapy compares favorably to simple chemotherapy in the treatment of non-small cell lung carcinoma.

Objective To explore the effect of ceftriaxone combined with rifampicin in the treatment of children with purulent meningitis,thus to provide reference for related studies.Methods 120 children with purulent meningitis were selected and randomly divided into observation group(67 cases) and control group (53 cases) according to the digital table.The control group received treatment of ceftriaxone,and the observation group received ceftriaxone and rifampicin.The clinical effect,recovery time of clinical indicators,total protein (TP),C-reactive protein (CRP),and serum protein C level were observed in the two groups.Results After treatment,the total effective rate of the observation group was 97.01%,which was higher than 86.79% of the control group,the difference was statistically significant(x2=4.457,P<0.05).The recovery time of body temperature,peripheral leukocyte count,and CSF leukocyte in the observation group were (2.35±0.68)d,(5.27±1.56)d,(13.27±1.71)d,respectively,which in the control group were shorter than (3.36±0.36)d,(7.24±2.09)d,(16.74±2.66)d,respectively,the differences were statistically significant(t=-9.713,-5.926,-8.643,all P<0.05).After treatment,the TP and CRP decreased in two groups,serum protein C was increased,and the above indicators of the observation group improved more significantly,there were statistically significant differences(all P<0.05).There was no significant differences in the incidence of complications between the two groups(P>0.05).Conclusion Ceftriaxone combined with rifampicin in the treatment of children with purulent meningitis can reduce inflammation and promote the recovery time of clinical indicators,and it's worthy of reference.

Objective To explore the activity signs and clinical value of CT in evaluation of anti -tuberculosis chemotherapy in elderly patients with active tuberculosis.Methods Clinical and imaging data of 78 cases with elderly active tuberculosis were retrospectively analyzed.The changes of CT sign between bacterium negative and posi-tive,before and after chemotherapy were compared.Results The detection rates of ground glass opacity,thick -walled cavity in bacterium positive were 72.1% and 55.8%,which were significantly higher than those in bacterium negative 45.7% and 28.6%(P <0.05).Compared with before chemotherapy,the detection rates of ground glass opacity,tree -in -bud,thick -walled cavity,pulmonary consolidation,centrilobular nodule,lobular consolidation after chemotherapy were significantly reduced(P <0.05).The active CT signs of ground glass opacity,tree -in -bud were completely absorbed,and other signs were lapsed to non -active signs including cord -like shadow,thin -walled cav-ity,calcification,bronchia aggregation and circuity.Conclusion There is conversion rule of CT signs in elderly active pulmonary tuberculosis before and after anti -tuberculosis chemotherapy,and CT is helpful in the evaluation of anti -tuberculosis chemotherapy results of active tuberculosis.

SUMMARY In recent years, successful pregnancies in renal transplant women have been reported worldwide. However, pregnancy in renal trasplant recipient is relatively rare in China. This paper reported a case of pregnancy 2 years post renal transplant. At the end of 28 weeks' gestation she had abnormal liver and renal function complicated with severe preeclampsia. Literatures were reviewed on considerations about pregnancy in renal transplant women. Maternal and neonatal outcomes can be improved by intensive care during pregnancy, proper immunosupression and timely termination of pregnancy.

Objective:To investigate the principle of compensation speech of patients with cleft palate (CP). Methods: Misarticulation was examined by acoustic analysis technology when pronouncing chinese consonant /t/, /s/ and /d/ in 72 post-operation CP children and 9 normal children. And the pronunciation was characteristiced by the voice starting time(VOT) and the distribution of strong force frequency etc. Results:There were less VOT time and append lower strong force frequency in cleft palate children. Conclusion: The characteristic of pronunciation compensation of the patients with CP is the two-time-disblock. f

Objective To evaluate the early diagnosis value of blood neutrophil gelatinase-associated lipocalin (NGAL) and interleukin-18 (IL-18) in patients with sepsis-induced acute kidney injury (AKI). Methods A prospective case controlled study was conducted. Fifty-six patients with sepsis but without renal disease admitted to intensive care unit (ICU) of Shanxi People's Hospital from April 2014 to April 2015 were enrolled. Blood lactic acid and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score at ICU admission were recorded. The urine output, blood urea nitrogen (BUN), serum creatinine (SCr), NGAL, IL-18 and tumor necrosis factor-α (TNF-α) were continuously monitored for 48 hours. The patients were divided into AKI group and non-AKI group according to the diagnostic criteria of Kidney Disease: Improving Global Outcomes (KDIGO). The changes trend in above parameters between the two groups at different time points were compared. The early diagnostic value of NGAL, IL-18, and SCr for sepsis-induced AKI was evaluated by receiver operating characteristic curve (ROC). Results Compared with non-AKI group, with the time prolongation after ICU admission, the traditional parameters reflecting AKI urine output in sepsis-induced AKI group was decreased gradually, BUN and SCr were gradually increased, and a statistically significant difference was found at 12 hours between the two groups [BUN (mmol/L): 11.8±3.5 vs. 8.2±3.5, SCr (μmol/L): 88.6±11.3 vs. 74.0±11.0, both P < 0.01]; but the new indicators NGAL and IL-18 reflecting AKI had a statistically significant difference at 6 hours [NGAL (μg/L): 426.7±90.7 vs. 382.3±67.9, IL-18 (ng/L): 75.7±9.3 vs. 70.9±7.3, both P < 0.05]. It was shown that in AKI group, NGAL and IL-18 compared with BUN and SCr increased at least 6 hours ahead of schedule. The area under ROC curve (AUC) of 6-hour NGAL and IL-18 in patients with sepsis-induced AKI were 0.821 [95% confidence interval (95%CI) = 0.713-0.931] and 0.719 (95%CI = 0.584-0.853) respectively, superior to SCr (AUC = 0.677, 95%CI = 0.528-0.825). The cutoff value of NGAL was 363.58 μg/L, and the sensitivity and specificity were 88.0% and 86.7% respectively. Conclusions NGAL and IL-18 in the early prediction of sepsis patients with AKI are better than SCr, and NGAL was most sensitive. Therefore, NGAL can be used as an early biomarker for the diagnosis of AKI in patients with sepsis.