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Objective To describe the Xinjiang region of tuberculous meningitis (TBM) (age ＞ 18 years of age) in patients with the clinical features,analysis of factors influencing the prognosis.Methods A retrospective of cases included in the data collection,describe the clinical characteristics,using the single factor and multiple factors Logistic regression analysis of factors influencing the prognosis.Results A total of 200 cases of TBM patients had the following characteristics:120 cases of male,female 80 cases;age 18 -75 (37.35 ±+ 14.24) years old;the course of the disease 3-270 (36.86 +43.86)days;and 179 cases of survival,21 cases of death,with a mortality of l0.5％.Single factor analysis showed that hydrocephalus,encephaledema,clinical staging,erythrocyte sedimentation rate,cerebro-spinal fluid (CSF)-protein had statistically significant difference between survival group and death group,respectively (P ＜ 0.05).The multi-factor Logistic regression analysis showed that encephaledema and erythrocyte sedimentation rate were independent factors to affect the prognosis of TBM (P ＜ 0.05).Conclusions Encephaledema and erythrocyte sedimentation rate are independent risk factors of poor prognosis in patients with TBM,early identify predictors,formulate corresponding clinical countermeasures,and can improve the prognosis of patients with tuberculous meningitis.
ABSTRACT
Objective To explore the effect of early administration of high-dose amino acids in parenteral nutrition for low birth weight infants of prematurity.Methods A total of 191 prematures admitted to the First Affiliated Hospital of Nanjing Medical University from June 2015 to December 2016 were selected,and they were randomly divided into the study group (n =110) and the control group (n =81).The starting amino acid dose was 1.8-2.5 g/(kg · d)and 1.0-1.5 g/(kg · d) in the study group and the control group,respectively.Lipids,glucose,and electrolytes in parenteral nutrition were applied according to standard protocol of the guideline.And the start of enteral feeding,the recovery of birth weight,the duration of parenteral nutrition,the time before total enteral nutrition,duration of hospital stay,incidence of respiratory distress syndrome,duration of mechanical ventilation and incidence of kaliopenia were compared between the 2 groups.Results The start of enteral feeding,the recovery of birth weight,the duration of parenteral nutrition,the time before total enteral nutrition in the study group were earlier than those in the control group [(3.83 ±3.15) d vs.(5.53 ±5.63) d,(15.47±10.54) d vs.(19.47 ± 14.57) d,(16.46 ± 10.33) d vs.(21.41 ±18.00) d,(6.36 ± 4.88) d vs.(8.48 ± 9.27) d],and the differences were all statistically significant (t =2.455,2.097,2.217,2.041,P =0.016,0.038,0.029,0.043).The duration of hospital stay was shorter and the hospitalization expenses were lower in the study group than those in the control group,but the differences were not significant (all P ＞ 0.05).The incidence of respiratory distress syndrome in the study group was significantly lower than that in the control group[20.91％ (23/110 cases) vs.35.80％ (29/81 cases)],and the difference was statistically significant (x2 =5.223,P =0.022).The duration of mechanical ventilation in study group was shorter than that in control [(1.12 ± 2.62) d vs.(3.31 ± 8.13) d],and the difference was statistically significant (t =2.231,P =0.028).The incidence of kaliopenia in the study group was higher than that in the control group [30.91％ (34/110 cases)vs.17.28％ (14/81 cases)],and the difference was statistically significant (x2 =4.603,P =0.032).There were not significant differences in terms of complications of necrotizing enterocolitis,sepsis,extrauterine growth retardation,hospital infection,metabolic acidosis,hyperglycemia,glucopenia,patent ductus arteriosus and respiratory distress syndrome between 2 groups (all P ＞ 0.05).Conclusions Early administration of high-dose amino acids in parenteral nutrition for preterm infants can result in earlier enteral nutrition,shorter parenteral nutrition duration without increasing incidence of complications and hospitalization expenses.
ABSTRACT
Objective A retrospective analysis was carried out for the classification and character-istics of fever of unknown origin, and its trend in recent years. Methods A total of 1192 patients with fe-ver of unknown origin, who were admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2010 to December 2016, were enrolled in this study. Descriptive analysis of the proportion, charac-teristics, and trend different diseases in the fever of unknown origin was performed. Results A total of 1080 cases was diagnosed in 1192 patients, with a diagnosis rate of 90. 6％. The final diagnoses included infections, inflammatory diseases, malignancies and miscellaneous conditions in 72. 9％, 9. 1％,5. 1％ and 3. 4％ of subjects, whereas 9. 4％ of cases remained undiagnosed. The results of variance analysis showed that the white blood cells and hemoglobin of infectious diseases were higher than those of connective tissue disease and malignancy were respectively [(11. 12 ± 2. 58) × 109/L vs (8. 82 ± 1. 12) × 109/L vs (9. 67 ±2.76) ×109/L, (116.81 ±20.77)g/L vs (103.25 ±22.84)g/L vs (102.30 ±25.14)g/L], While period of hospitalization and erythrocyte sedimentation rate were lower than that of connective tissue disease and malignancy were respectively [ ( 12. 15 ± 7. 91 ) days vs ( 19. 94 ± 10. 17 ) days vs ( 18. 85 ± 14. 37 ) days, (48.12 ±20.93)mm/h vs (58.13 ±20.24)mm/h vs (56.9 ±20.52)mm/h], and the age of ma-lignant was higher than that of infectious disease and connective tissue disease were [(56. 38 ± 17. 57)years vs (45. 99 ± 16. 79)years vs (41. 09 ± 16. 79)years], the difference was statistically significant (P<0. 05).The rank sum test showed that eosinophils, lymphocytes and interleukin-6 were not equal ( P <0. 05 ) . Conclusions Infectious diseases in fever of unknown origin ( FUO) are still the main cause. whereas blood cells, eosinophils, lymphocytes, hemoglobin,erythrocyte sedimentation rate, interleukin 6, age and hospi-talization time were predictive of disease diagnosis. In recent years, there was no obvious trend of all kinds of diseases.