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The predictive value of APACHEⅡ and TISS-28 in the treatment to respiratory failure in acute exacerbation of chronic obstructive pulmonary disease

Xiyuan XU ; Yikai YAO ; Jingping YANG

Chinese Journal of Practical Internal Medicine.2000;0(12):-.

Objective Estimating the treatment to respiratory failure in acute exacerbation of chronic obstructive pulmonary disease by scores in the form of quantitative assessment.Methods 156 patients with chronic obstructive pulmonary disease with acute exacerbation of respiratory failure in patients in the medical intensive care unit based on the worst value of the calculated APACHEⅡ score were grouped,divided into groups and pairs of oxygen the level of non-invasive positive pressure ventilation group.Based on the worst values calculated by the APACHEⅡ and TISS-28 score within 24 h after admission into MICU selected cases is re-grouped into an effective group of oxygen,BiPAP effective group and invasive ventilation group.Statistics separately for each group of patients with APACHEⅡ score and TISS-28 score range,length of stay.Results The invasive ventilation group APACHEⅡ score(27.44?6.79)and TISS-28 score(28.22?7.90)was significantly higher than the other groups(P0.05),invasive ventilation group and effective group MICU hours of BiPAP have significant difference(P

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A questionnaire survey of allergic rhinitis in bronchial asthma patients

Yuan YUAN ; Lingfei KONG

Chinese Journal of Practical Internal Medicine.2000;0(12):-.

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Obstructive sleep apnea syndrome caused by pituitary tumor in a man:a case report

Yinghui GAO ; Quanying HE

Chinese Journal of Practical Internal Medicine.2000;0(12):-.

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Safety of antidepressant treatment of coronary heart disease accompanied with depression

Mingming JIANG ; Dongmei SHI

Chinese Journal of Practical Internal Medicine.2000;0(12):-.

Cardiovascular disease has become the first cause of human death.Among the many risk factors in coronary heart disease,depression has been identified as an independent prognostic risk factors.In patients with coronary heart disease accompanied by severe depression,the onset of angina,quality of life deterioration and the mortality will increase by 3～5 times.However,the majority of antidepressant drugs have adverse effects on cardiovascular disease adverse drug reactions,making coronary heart disease patients with depression,did not receive antidepressant treatment due.So more researches to clarify the anti-depressant drugs,safety for cardiovascular disease are needed.

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Advances on treatment of myasthenia gravis

Yongliang TENG ; Xinmei JIANG

Chinese Journal of Practical Internal Medicine.2000;0(12):-.

Myasthenia gravis(MG)is an acquired autoimmune disease,which is mediated by nicotinic acetylcholine receptor(AChR)antibody,depends on cellular immunity and involves some complements.It mainly affects AChR on the postsynaptic membrane at the neuromuscular junction(NMJ).Various therapeutic methods have been used in the treatment of MG,but current therapeutic methods can not do well when used alone,and most current drugs have major side effects due to immunosuppression,We expect that novel therapies be discovered.

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The influence factors for hepatitis B virus re-infection after liver transplantation

Fengshui WANG ; Zhongyang SHEN ; Guiyu YUAN ; Qian LI ; Zhijun BU ; Xiaomei WANG ; Yu MAO

Chinese Journal of Practical Internal Medicine.2000;0(12):-.

Objective To study the influence factors for HBV reinfection following liver transplantation.Methods 92 cases of liver transplantation were enrolled for open non-randomized clinical study.Given conventional OLTx and immunosuppressive agents and antibiotics to prevent infection etc,patients are divided into lamivudine alone and HBIG combined with lamivudine group.Observation of postoperative liver function,HBV serum markers,HBV DNA in PBMC,YMDD and HBV S gene mutation,liver tissue IH etc.Results In 92 cases of liver transplantation with HBV-related liver disease,hepatitis B recurrence rate was 4.35%(4/92).In lamivudine group the HBV infection rate was 35%(7/20);In combined therapy group the HBV infection rate was 6.94%(5/72).With preoperatively negative HBV DNA negative the hepatitis B recurrence rate was 0;With preoperatively positive HBV DNA,the postoperative HBV infection rate was 17.39%(12/69),which had cases with S gene or YMDD mutation.In patients with negative HBV DNA before and after operation,the HBV re-infection rate was 11.11%(1/9);In 5 cases with preoperative HBV DNA positive,the HBV infection rate was 4/5 after LTx;before and after operation HBV DNA are positive,the HBV infection rate was 100%(3/3);the preoperative HBV DNA positive and postoperative HBV DNA negative,the HBV infection rate was 50%(1/2).Conclusion To prevent HBV infection after LTx,lamivudine group easily leads to HBV re-infection than HBIG combined with lamivudine group.Preoperative serum HBV DNA positive,preoperative and postoperative HBV YMDD and S gene mutation are the primary factors affecting the HBV re-infection after operation.HBV DNA positive in PBMC is the source of HBV re-infection,but also the factor of recurrence of hepatitis B.

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The discussion of adult Still diseases' diagnosis and treatment

Zhongwei TAO

Chinese Journal of Practical Internal Medicine.2000;0(12):-.

The diagnosis of adult-onset still's disease currently reguires application of Yamaguchi's criteria and then exclusion of infectious,neoplastic and other rheumatic disorder.A recent article suggests that very high level of serum ferritin together with an unusually low percentage of glycosylated ferritin may serve as diagnostic criteria or even as a marker of disease progression.This new indicator has greater specificity than the others,including that of Yamaguchi.Ferritin and giycosylated ferritin levels are interesting diagnostic markers.The new score suggested by Fautrel et al.is especially useful in that it does not reguire the exclusion of a list of differential diagnoses.The recently reported use of anticytokine agents in patients refractory to conventional treatment is also reviewed in this article.

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The change of calcitonin gene-related peptide and NO in the early diabetic nephropathy and the intervention by angiolensin Ⅱ receptor antagonist

Cuiping CAO ; Hongyu ZHAO ; Guoliang LIU ; Weiwei DENG ; Jiashu LI

Chinese Journal of Practical Internal Medicine.2000;0(12):-.

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Clinical characteristics of primary hyperparathyroidism

Honghua WU ; Zhonghe WEI ; Yanming GAO ; Xiaohui GUO

Chinese Journal of Practical Internal Medicine.2000;0(12):-.

Objective To analyze the characteristics of PHPT patients of our hospital.Methods Retrospective analyze 82 PHPT patients who hospitalized in our hospital from 1974 to 2006,male 41,female 41,age 16～83 years,course 1 month～40 years.All of the final diagnosis was PHPT clinically,while 67 were confirmed by pathology.Results (1)The number of diagnosed PHPT patients was increasing year by year,the cases diagnosed in 2002—2006 were more than the sum of past years.(2)The first visit department was widespread for PHPT patients,up to 47.6% went to urology department firstly,while only 24% went to endocrinology department.(3)Clinical presentation:42.7% patients presented simple urinary system calculus,15.9% ostalgia with urinary system calculus,17.1% simple ostalgia,while 20.7% with pathologic fracture,and 7.3% chronic renal failure,3.6% peptic ulcer,2.4% chronic pancreatitis.69.5% occurred typical hypercalcinemia and hypophosphatemia,30.5% revealed hypophosphatemia chiefly.(4)The coincidence rate between the examinations preoperation and pathology:B type ultrasound 64.5%,CT scan 37.3%,99m Tc-MIBI scan 90%.(5)Pathology presentation:73% single adenoma,17.9% hyperplasia,2.9% adenoma with hyperplasia,1.5% carcinoma,other 4.5% only seen some parathyroid tissue.Conclusion PHPT patients have various clinical presentation,so there are generally missed diagnosis and misdiagnosis.we should investigate serum calcium,phosphate and PTH level to exclude PHPT.

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Insulin therapy for blood glucose fluctuation in diabetes

Xinxia ZHANG ; Nanwei TONG

Chinese Journal of Practical Internal Medicine.2000;0(12):-.

For different individuals with diabetes,blood glucose control varies.In the blood glucose controlling,blood glucose levels are sometimes higher than the target,sometimes the diabetic patients may develop hypoglycemia.In insulin therapy for blood glucose fluctuations,the most important thing is to avoid hypoglycemia.Finding out regular patterns of blood glucose fluctuations,then according to that,we need to choose the right insulin preparations to treat the condition.For the patients with irregular fluctuations of blood glucose,insulin pump therapy should be a proper choice.

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