ABSTRACT
Objective:To investigate the clinical features, therapy and prognosis of human cytomegalovirus(HCMV)pneumonia in pediatric patients, and to analyze the diagnosis value of detecting HCMV DNA in bronchoalveolar lavage fluid(BALF)by real-time PCR.Methods:The clinical characteristics of 58 pediatric inpatients who were HCMV DNA positive in BALF were retrospectively reviewed.All the patients were from Shengjing Hospital of China Medical University from January 2015 to December 2019.Clinical, radiologic, laboratory and microbiologic data was collected for each patient.The study cohort was divided into HCMV productive infection and latent infection consisting of 22 and 36 patients respectively, based on the HCMV active infection in lung or not.Receiver operating characteristic(ROC)curve was used to assess utility of detecting HCMV DNA in BALF and establish a threshold for diagnosis.Results:(1)Compared with patients in latent infection group, the children in productive infection group had a lower age of onset( P<0.05), a higher proportion of male( P<0.05), and more prolonged hospitalization stay( P<0.05). Pulmonary rales, hypoxemia and higher AST, CK, LDH in serum were easier to detect in productive infection group( P<0.05). Higher HCMV DNA copies in BALF was also detected( P<0.01). Patients in productive infection group had significantly more exposure to additional oxygen treatment or mechanical ventilation and systemic hormone therapy( P<0.05), while with poorer outcomes( P<0.05). (2) ROC curve analysis showed that the AUC for HCMV DNA in BALF in diagnosis of HCMV pneumonia was 0.708 with a threshold of 8.83×10 3 copies/mL, a sensitivity of 77.27%, and a specificity of 58.33%. Conclusion:Those who are diagnosed HCMV pneumonia have a lower age of onset with higher male proportion.These children suffered severer clinical signs.The patients with HCMV DNA copies higher than 8.83×10 3 copies/mL in BALF would be more likely to be diagnosed as HCMV pneumonia.
ABSTRACT
Olive oil is one of the important byproducts in agriculture. It is rich in oleuropein, which can be hydrolyzed into several bioactive phenolic compounds, including hydroxytyrosol (HT).There are many literatures have been confirmed that HT has significant pharmacological effects in the anti-inflammatory, anti-virus, regulation of metabolic disorders and treatment of degenerative diseases. However, HT has severe instability in vivo and in vitro. It is a challenge how to improve its stability through structural transformation or utilization of pharmaceutical means to processing. This paper will focus on biological activity of HT and its stability improvement, and provid some new ideas for expanding the research and promoting the development of HT in the field of Medicine.
ABSTRACT
Objective To explore the therapeutic effects of two kinds of operation mode of inferior temporal muscle bone flap craniotomy and traditional big bone flap craniotomy in treatment of hypertensive cerebral hemorrhage patients with early cerebral hernia?Methods Sixty?four cases patients of hypertensive cerebral hemorrhage with early cerebral hernia,treated in Huxi Hospital Affiliated to Jining Medical College from January 2011 to January 2015 were randomly divided into observation group ( 32 patients underwent temporal muscle bone flap craniotomy) and control group ( 32 patients underwent traditional big bone flap craniotomy)?The incidence rate of complications,mortality within 3 months,the excellent rate of GOS score on 6 months after the onset were compared?Results The mortality rate of 3 months after operation in the observation group was 9?4%( 3/32) ,in the control group was 12?5%( 4/32) ,the difference between the two groups was not significant (χ2=0?00(correction),P>0?05))?There were 7 cases had severe complications in the observation group,the incidence rate was 21?9%( 7/32 );there were 16 patients had serious complications in control group, the incidence rate was 50%( 16/32) ,the difference was statistically significant between the two groups(χ2=5?50,P<0?05)?There were 7 cases recovered well,8 cases were residual,the excellent rate of GOS score was 46?9%( 15/32) in the observation group;there were 4 cases recovered well,3 cases were residual,the excellent rate of GOS score 21?9%( 7/32) in the control group,the difference was statistically significant(χ2=4?27,P<0?05)?Conclusion For patients with hypertensive cerebral hemorrhage in basal ganglia region in the early stage of cerebral hernia,temporal muscle bone flap craniotomy hematoma removal can also effectively relieve the hernia, compared with traditional big bone flap craniotomy, can significantly reduce the incidence of complications, improve the prognosis of the patients.
ABSTRACT
Objective To evaluate the clinical effect of the simple syringomyelia patients with syringopleural shunt (SPS) and syringosubarachnoid shunt (SSS).Methods Twenty-eight patients with syringomyelia were selected as our subjects.Of which,18 patients were operated with SPS and 10 cases were with SSS.The therapy effect was compared between groups.Results All patients were checked with MRI 3 months after the operations and showed that syrinx cavity was significantly narrow of all patients.At early stage (48 h) after surgery 9 cases in SPS and 4 cases in SSS were showed the decrease syrinx cavity.Among patients with SPS,15 cases (83.3％) had the symptoms and signs improved,1 case (5.5％) withno changes,1 case (5.5％) with worse effect,and 1 cases(5.5％) occurred the tethered spinal cord.Meanwhile,among,patients with SSS,8 cases(80.0％) had the symptoms and signs improved,1 case(10.0％) with no changes,and 1 case (10.0％) with worse effect.There were 4 patients with pneumothorax in SPS group after operations,and the lung compression ratios were less than 5％.These cases were not taken any special treatment for the pneumothorax.All patients in two groups had not been infected and pleural effusions.No cases had taken the tube plugging.Conclusion The simple syringomyelia patients with the spine injury should take the cavity shunt.The SPS has some advantages because it can provide the partly negative pressure.But it should be certified by more cases and a long-time follow up.
ABSTRACT
Objective To observe the clinical effect of the combined medication to prevent postoperative adjuvant chemotherapy-related nausea and vomiting after lung cancer surgery.Methods One hundred and fifteen patients under cisplatin-based chemotherapy were randomly divided into the control group ( n =58 ) and the treatment group( n =57 ).For the control group,Azasetron ( day 1-5 ) and dexamethasonewere (day 1-3 )were injected intravenously with a dose of 10 mg/day at half an hour before chemotherapy.For the treatment group,intramuscularinjectionof promethazine (25mg/day,30minsbeforesurgery ) and metoclopramide( 10 mg/day,30 mins before surgery )and intravenous infusion of omeprazole (40 mg/day,45 mins before surgery)were given from day 1 to day 5 in addition to the treatment for the control group to relieve chemotherapy-induced acute and late-phased nausea and vomiting.ResultsThere were no significant differences between the two groups in controlling acute nausea and vomiting in terms of complete response rate (Ps ＞0.05 ).However,there were significant effect on late-phased nausea,with an effective rate of 87.7％(50/57) in the treatment group versus 72.4％ (42/58) in the control group at day 2 after treatment( x2 =4.21,P ＜ 0.05 ),and 84.2％ (48/57) vs.67.2％ ( 39/58 ) at day 3 ( x2 =4.49,P ＜ 0.05 ),91.2％ ( 52/57 ) vs.77.6％ (45/58) at day 4 ( x2 =4.05,P ＜ 0.05 ),94.7％ ( 54/57 ) vs.81.0％ ( 47/58 ) at day 5 ( x2 =5.04,P ＜ 0.05 ).Furthermore,there were significant effect on late-phased vomiting,with an effective rate of 91.2％ (52/57)in the treatment group versus 74.1％ (43/58) in the control group at day 2 after treatment ( x2 =5.84,P ＜ 0.05 ),and 91.2％ ( 52/57 ) vs.70.7％ ( 41/58 ) at day 3 ( x2 =7.84,P ＜ 0.05 ),94.7％ ( 54/57 ) vs.79.3％ ( 46/58 ) at day 4 ( x2 =6.03,P ＜ 0.05 ),98.2％ (56/57) vs.87.9％ (50/58) at day 5 ( x2 =5.77,P ＜ 0.05 ).The common side effect in both group were dizzy,headache and coporostasis,with no significant difference [ 15.8％ ( 9/57 )vs.20.7％(12/58),x2 =0.46,P=0.49 ].ConclusionThe combinational medication used in the treatment group prominently reduced the incidence of chemotherapy-induced nausea and vomiting after pneumonectomy,especially the late-phased nausea and vomiting.
ABSTRACT
Objective To gain more pathophysiolgic knowledge about acute obstructive hydrocephalus and to explore its rapid and effective treatment by establishing canine acute obstructive hydrocephalus model.Methods Acute obstructive hydrocephalus model was established by injecting cyan-acrylic gel glue into the fourth ventricle via posterior fosse craniotomy in 9 male adult mongrel dogs.At the same time,lateral ventricle catheterization were performed and were fixed on the scalp to connect reservoir bag so that the changes of intracranial pressure (ICP) could be measured dynamically,and the changes of neurological function were observed.Results Acute obstructive hydrocephalus model was successfully established in 6 of the total 9dogs.ICP was (48.2 ± 6.1 ) cm H2 O at 48 hours after the injection and was (56.4 ± 5.7 ) cm H2 O at 72 hours after the injection,it increased 392％ and 459 ％ respectively.And the ICP after injection was significantly different(P ＜ 0.01 )compared with that before injection (12.3 ± 3.1 )cm H2O.Conclusion The establishment of acute obstructive hydrocephalus model has high success rate,and is easy to reduplicate; ICP could be measured dynamically and also could be reduced by releasing CSF;Thus,ventricular drainage is the most rapid and effective treatment for acute obstructive hydrocephalus.
ABSTRACT
Objective To explore the efficacy, operation timing and techniques of surgical treatment in patients with the anterior communicating aneurysms. Methods We retrospectively analyzed the surgical procedures and effectiveness of 158 patients with anterior communicating aneurysms. Ten of the 158 cases were combined with aneurysms in other branches. All patients had experienced SAH (5 cases were not relevant to anterior communicating aneurysm) and received incarceration of aneurysms through the orbit-pterion approach. Preoperative Hunt-Hess grade;the number of patients with grade Ⅰ,Ⅱ, Ⅲ,Ⅳ and Ⅴ were 24,45,54,31 and 4,respectively. Fourty-four cases received surgery within 3 days after SAH,74 cases within 4 to 14 days,and 40 cases after 14 days. Results According to GOS grade; 138 cases (87. 34% ) recovered with good outcome,9 cases (5.69%) with moderate disability, 6 cases (3.80%) with severe disability, and 5 death (3. 16%, including cases giving up treatment). Among the 138 patients having good outcomes,24 were grade Ⅰ ,42 grade Ⅱ ,47 grade Ⅲ and 25 grade Ⅳ. Thirty-nine cases underwent surgery within 3 days,64 within 3 to 14 days,and 35 after 14 days. Conclusion The surgical timing of anterior communicating aneurysms should be decided according to comprehensive analysis of CT, DSA, and detailed neurologic examination of the patients. Orbit pterion approach is favorable for exposing aneurysms. A series of actions,such as reducing intracranial pressure, cerebral protection and 3H therapy,will help to improve the prognosis of the patients .
ABSTRACT
Objective To investigate the therapeutic method and effect of thrombolysis via super-selective ophthalmic artery catheterization treating central retinal artery occlusion (CRAO). Methods 9 patients with CRAO were treated by urokinase infusion via super-selective ophthalmic artery catheterization with Seldinger technique. Results In the 9 patients, the visual acuity was improved to different extent in 8, and remained unchanged in 1. No complications was found during the treatment in any patients. Conclusions Thrombolysis via super-selective ophthalmic artery catheterization for CRAO can improve the visual acuity of most of the patients in different degrees. No positive relation exists in clinical therapeutic effect, time of onset, quantity of urokinase and the visual acuity before the treatment. The method of thrombolysis via super-selective ophthalmic artery catheterization for CRVO is safe and reliable.