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The Clinical Efficacy of Phentolamine in Treatment of Severe Hand-foot-mouth Disease

Qiong LIU ; Zengqing DU ; Yanchun WANG ; Yongkun HUANG ; Mei LIU

Journal of Kunming Medical University.2013;(12):117-118.

Objective To observe the clinical curative effect of phentolamine in the treatment of severe hand-foot-mouth disease (HFMD) . Methods We observed the clinical symptoms and related index changes before and after treatment of 62 cases of severe HFMD patients who were treated by the basis of conventional therapy with additional phentolamine. The blood pressure of patients was closely monitored,and the dosage of phentolamine was adjusted. Result The blood pressure and heart rate of sick children who used phentolamine improved significantly, the difference was statistically significant ( <0.05) . Conclusion Phentolamine has significant clinical curative effect in treatment of server HFMD.

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A Comparative Study of Aripiprazole and Risperidone in the Treatment of Alzheimer’s Disease Dementia Combined Psychiatric Symptoms

Donghui HU ; Ajing WANG

Journal of Kunming Medical University.2013;(12):114-116.

Objective To investigate and compare the therapeutic effect of aripiprazole and risperidone in the treatment of psychiatric symptoms in Alzheimer’s disease dementia. Methods 64 patients of Alzheimer's disease dementia with psychiatric symptoms,were divided into risperidone donepezil group (A) and aripiprazole donepezil group (B ) . Before and 4, 8 weeks after treatment, the BEHAV-AD scale was used to assess the pathological behavior and the side effects scale (TESS) was used to assess adverse drug reactions.Results A group at 4 weeks after treatment BEHAV-AD score showed no significant difference with before treatment ( >0.05), 8 weeks after treatment decreased significantly (<0.05) . Group B 4 weeks and 8 weeks after treatment BEHAV-AD score was significantly decreased ( <0.05) . BEHAV-AD score in Group B 4 weeks and 8 weeks after treatment was significantly lower than group A ( <0.05) .The scores in behavioral disorders, depression, anxiety in Group B were significantly lower than group A ( <0.05), the scores in paranoia ,hallucinations,aggressive behavior, delirium showed no significant difference between two groups ( >0.05) . 4 weeks after treatment,the two groups had no significant difference in TESS score ( >0.05), 8 weeks after treatment the TESS scores in group B were significantly lower in group A ( <0.05) .Conclusion Aripiprazole + donepezil can effectively alleviate the symptoms of these patients with lower mental side effects, and has better effect in treatment of Alzheimer's disease dementia with psychiatric symptoms.

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The Correlation between MSCT Morphology and Lung Function Index of Emphysema

Yalv GU ; Xin LU ; Ying WANG ; Limin YANG ; Jingang HAO ; Jingting QIN

Journal of Kunming Medical University.2013;(12):105-109.

Objective To discuss the correlation between MSCT morphological index of emphysema and pulmonary function test (PFT) indexes. Methods We randomly selected 33 cases with chronic obstructive pulmonary disease (COPD),and conducted CT and PFT in a week. The whole lung was scanned by MSCT at the end of deep aspiration,and the post-processing workstation was used for quantitative determination of a total of 12 morphological indexes,including the density of lung, pulmonary diameter line,lung volume,and etc,then their correlation with lung function index was analyzed.Results FEV1.0%had correlation with upper right lung density ( =0.391, =0.391), lower right lung density ( =0.465, =0.038),the mean lung density ( =0.576,=0.576), and total lung capacity (=0.471, =0.471),upper right lung volume ( =0.413, =0.049) . FEV1.0/FVC had correlation with left lower lung density ( =0.392, =0.024), the mean lung density ( =0.703, = 0.000), total lung transverse diameter ( = 0.521, = 0.521), upper right lung maximum transverse diameter ( =0.627, =0.627), and total lung capacity ( =0.549, =0.549) correlation. FVC had correlation with upper right lung maximum transverse diameter ( = 0.378, = 0.378), characterized by maximum transverse diameter (=0.349, =0.037) . TLC had correlation with mean lung density (=0.523,=0.523), upper right lung maximum transverse diameter ( =0.454, =0.454), and total lung capacity (= 0.001), the right lung volume ( = 0.492, = 0.492) . Conclusion MSCT lung morphology quantitative indicators have good clinical application value in the diagnosis and assessment of emphysema patients.

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Monitoring and Analysis of Paroxysmal Atrial Fibrillation and Its Related Triggering Factors by 12-leads HOLTER

Jili CHEN ; Wei WANG

Journal of Kunming Medical University.2013;(12):100-104.

Objective To apply 12-leads HOLTER monitoring and analysis to observe paroxysmal atrial fibrillation (PAF) and its related atrial arrhythmias so as to explore the triggering factors of PAF. Methods 47 patients with PAF, including 20 male patients and 27 female patients, were given 12-HOLTER monitoring and analysis. Their average age was 64.89 ±12.70 years-old.PAF patients were subdivided into 2 subgroups: the triggered PAF subgroup and the untriggered PAF subgroup. Patients with atrial premature beats but without PAF were selected into the control group. The PAF and its related atrial arrhythmias were detected and analyzed by 12-HOLTER.Results (1) 9 events of PAF were found in 47 patients by 12-HOLTER monitoring and analysis, among them 72 events of PAF were triggered by atrial premature (AP) (91.1%, 72/79), 6 events of PAF occurred automatically and suddenly (7.6%, 6/79);and only 1 events of PAF was triggered by atrial flutter (1.3%,1/79) . (2) The coupling interval of AP in the triggered PAF subgroup was significantly shorter than that of the untriggered PAF subgroup and control group (490 ±90ms vs. 590 ±140 ms and 630 ±90ms, <0.05);The index of AP was smaller significantly in the PAF group than that of the untriggered PAF subgroup and controll group (0.52±0.12 vs. 0.62±0.09 and 0.71±0.06, <0.05);TheP' on Tof AP was significantly higher in the PAF group than that of the untriggered PAF subgroup and control group (84.72%vs. 26.73%and 2.78%, <0.017);The interval before the AP in PAF group was prolonged more significantly than that of controlled group (990±280 ms vs. 940±210 ms, <0.05) . (3) During 2 min~30 s before the PAF occurrence control as total times,the AP appeared more frequently (from 0.43 beats/min to 3.5~6.00 beats/min, <0.017) . (4) Most of the AP which triggered PAF was originated from the upper part of the left atrium (61/72,84.7%) .Conclusions Most events of PAF are triggered by AP, the AP which can trigger PAF may be of some of the features such as a shorter coupling interval,a smaller AP index,P' on Tand a longer interval before the AP,PAF more occurrence while the AP may take place more frequently.Most of the AP which triggered PAF are originated from the upper part of left atrium.

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Clinical Study of Dexmedetomidine Sedation in the ICU

Yun XIAO ; Yongshun WANG ; Minna DONG

Journal of Kunming Medical University.2013;(12):96-99.

Objective To observe the therapeutic effect and safety of dexmedetomidine for sedation in ICU. Methods We selected 40 patients who transferred to the ICU with retained endotracheal intubation after abdominal surgery under general anesthesia in this study. 40 patients were randomly divided into the dexmedetomidine group (D group,20 cases) and midazolam group (M group,20 cases) . Patients in group D were treated with loading dose 1 μg/kg from central vein pump injection 20 min, 1h according to Ramsay score for each adjustment of drug dose is pumped into 0.2 ~ 0.7 μg/(kg.h). Patients in M group were given a loading dose of midazolam 0.05mg/kg intravenous injection 1 min, depending on the degree of sedation maintenance dose of 0.02 ~ 0.1 mg/(kg.h). Pain scores every 2 h (NRS),when the NRS score>4 sharing,plus fentanyl 1μg/kg. When the patients achieved the offline condition, the endotracheal tube was pulled out. The sedation efficiency, dosage of fentanyl, after discontinuation wake-up time, extubation time, duration of mechanical ventilation, the incidence of cardiovascular events and delirium were compared between two groups.Results The sedation efficacy in Group D sedation was significantly higher than in group M ( <0.05) . Compared with group M, the dosage of fentanyl in patients in D group was significantly reduced ( <0.05), the wake time after stopping, extubation time were significantly shorter ( <0.05) . The incidence of cardiovascular events has no significant difference between two groups during the treatment. The incidence of postoperative delirium in D group was significantly lower than in that in group M ( <0.05) . Conclusions Dexmedetomidine has good sedative effect, and can shorten the time of extubation with hemodynamic stability and low incidence of delirium for patients in the ICU. It is an ideal ICU sedative.

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Comparison of the Curative Effect of Bare-handed Cardiopulmonary Rsuscitation and Cardiopulmonary Resuscitator in Rescue of Respiratory and Cardiac Arrest Patients

Lishan LIU ; Wei WEI

Journal of Kunming Medical University.2013;(12):84-86.

Objective To assess the clinical siginificance of the cardiopulmonary resuscitator in respiratory and cardiac arrest patients by comparing the curative effect of cardiopulmonary resuscitator and bare-handed cardiopulmonary resuscitation. Methods 102 patients on the verge of the death were randomiy divided into two groups and begin to CPR in four seconds after confirmation of respiratory and cardiac arrest. Patients in group 1 were given bare-handed CPR. Patients in group 2 were given cardiopulmonary resuscitation by cardiopulmonary resuscitator. Patients in both group 1 and group 2 received lasting CPR according to the 2010 GUIDE of CPR, then we observed their self-heart-beating, self-breathing, caroid puise, expression, puplillas, ECG. Results In the group 1,the effective case was 1,the non-effcctive cases were 63,the effective rate was 1.56%. In the group 2, the effective cases were 6, the non-effective cases were 31, the effective rate was 16.21%, there was a statistically significant difference between two groups ( <0.01) . Conclusion Cardiopulmonary resuscitator has good effect in cardiopulmomary resuscitation for respiratory and cardiac arrest patients, and the effective rate is significantly higher than bare-handed CPR,so it deserves clinical promotion.

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Comparative Study of the Curative Effect of Anatomical Plate and Locking Plate in Treating Calcaneous Intraarticular Fracture

Guohong LIU ; Di WU ; Hao YANG ; Qing LI ; Xiaosong ZHU ; Shihe LI

Journal of Kunming Medical University.2013;(12):77-83.

Objective To compare the curative effect of anatomical plate and locking plate in treatment of calcaneous intraarticular fracture. Methods 67 petiants with calcaneous intraarticular fracture were randomly divided into anatomical plate group (n=33) and locking plate group (n=34) . The Bo..hler angle, the Gissane angle, the length of calcaneal axis, the width and height of calcaneous and the Maryland grade were compared at 1 week and 6 month after operation. Results (1) week after operation, the Bo..hler angle, the Gissane angle, the height and width of calcaneous, the length of calcaneal axis, the Maryland grade had no significant difference between 2 groups . 6 months after operation, the Bo..hler angle, the Gissane angle, the height of calcaneous had significant differe nce between 2 groups. There was no significant difference in the length of calcaneal axis and the grade of Maryland between 2 groups. Conclusions The locking plate group is better than anatomical plate group in major anatomical measure indicators in 6 months follow up. The therapy of locking plate is worth of clinical promotion.

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Comparison of Two Kinds of Extracorporeal Shock Wave Lithotripsy in Treatment of 108 Cases of Ureteral Calculi

Haixiang GUO ; Pei LI ; Guang WANG ; Haiyan ZHANG ; Bowei YANG

Journal of Kunming Medical University.2013;(12):71-73.

Objective To evaluate of the clinical efficacy of two kinds of methods extracorporeal shock wave lithotripsy in treatment of ureteral calculi. Methods A retrospective analysis was conducted on the data of 108 patients with acute renal colic and ureteral stones (calculi diameter<2 cm) from March 2011 to April 2013. The patients were divided into two groups. 69 cases in A group underwent emergency positioning urography ureteral catheterization combined extracorporeal shock wave lithotripsy, 39 cases in B group underwent emergency extracorporeal shock wave lithotripsy. Results A group:lithotripsy was successful in 63 cases among 69 cases at the first time,the first success rate was 91.33% (63/69), the second success rate was 94.2%(65/69),2 cases of retrograde ureteroscopy failed, 2 cases of self-discharge after intubation stones, the recurrent renal colic rate was 14.3%(9/63),the use of analgesic drugs rate was 11.1%(7/63) . B group:the first success rate of stone clearance rate was 74.4%(25/39),the second success rate of stone clearance rate was 87.2%(34/39),5 cases underwent ureteroscopy lithotripsy, the renal colic recurrence rate was 20.5% (8/39), the use rate of analgesic drugs was 15.4% (6/39) . Conclusion Extracorporeal shock wave lithotripsy assisted by urography through retrograde ureteral catheterization has satisfying therapeutic effect in treatment of patients with ureteral calculi.

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Clinical Analysis of Entecavir in Treatment of 28 Cases of Hepatitis B-related Nephritis

Zhi AN

Journal of Kunming Medical University.2013;(12):68-70.

Objective To discuss the clinical effect of entecavir in treatment of hepatitis B-related nephritis. Methods 28 patients with hepatitis B-related nephritis diagnosed in our hospital through needling biopsy of kidney from 2009 to 2012 were selected in this study. All patients were given oral entecavir, besides conprehensive treatments,including potassium aspartate and diammonium glycyrrhizinate. The treatment course was three months. We observed and analyzed patients' serum glutamic pyruvic transaminase, serum albumin and urine protein within 24 hours after two treatment courses.Results After one treatment course, the overall effective rate was 82.14%. Two courses later, the overall effective rate was 96.43%. Patients' serum glutamic pyruvic transaminase, serum albumin and urine protein within 24 hours after two treatment courses had significant differences with those before treatment's,the difference had statistical significance ( <0.05),but serum creatinine had no significant change after treatment. Conclusion Entecavir has significant curative effect on hepatitis B-related nephritis.

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The Pregnancy Improvement of IVF-ET by Mental Intervention

Xianghui TANG ; Xiaogang CHEN ; Qiongfen ZHANG ; Shaoling YE ; Yueling CAO

Journal of Kunming Medical University.2013;(12):49-52.

Objective To study the effect of mental intervention on pregnant result in patients undergoing IVF-ET treatment.Methods 206 patients undergoing IVF-ET treatment in the hospital from February 2012 to Jan-uary 2013 were selected and randomly divided into two groups. The experiment group (n=103) was followed by mental intervention after the patients enrolled the IVF-ET treatment, the control group (n=103) enrolled the IVF-ET treatment without mental intervention.Results The HAMA and HAMD quantity grades for anxious and depression of patients in the experiment group were significantly lower than those of control ( <0.01), and the pregnancy rate of experiment group (45.63%) was higher than that of control (30.10%) <0.05. Conclusion Mental intervention for patients undergoing IVF-ET treatment could alleviate their anxiety-depression and improve the pregnancy rate of IVF.

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