ABSTRACT
<p><b>BACKGROUND</b>Community-acquired pneumonia (CAP) is a common infectious disease throughout the world and the incidence continues to grow as the population ages. Aspiration is an important pathogenic mechanism for pneumonia in the elderly and the management of patients with community-acquired pneumonia with aspiration factors is a major medical problem. Our study aimed to assess whether moxifloxacin in comparison to levofloxacin plus metronidazole are effective and safe in the treatment of community-acquired pneumonia with aspiration factors.</p><p><b>METHODS</b>In this prospective, multicenter, open-label, randomized controlled trial, 77 patients with mild-to-moderate community-acquired pneumonia with aspiration factors were enrolled and randomly assigned to receive moxifloxacin or levofloxacin plus metronidazole. The primary efficacy variables were clinical outcomes in evaluable patients at a follow-up visit 7 to 14 days after the end of therapy.</p><p><b>RESULTS</b>Seven days after the end of therapy a clinical cure was achieved for 76.7% (23 of 37) of efficacy-evaluable patients in the moxifloxacin group and 51.7% (15 of 40) of patients in the levofloxacin plus metronidazole group. There was a significant difference between the two groups (χ(2) = 4.002, P < 0.05). Bacteriological success rates were similar in the moxifloxacin group (93.3%) and levofloxacin plus metronidazole group (96.4%), there was no significant difference between the two groups (P > 0.05). The overall adverse event rate was 10.8% (4/37) in the moxifloxacin group versus 17.5% (7/40) in the levofloxacin plus metronidazole group, there was no significant difference between the two groups (P > 0.05). No serious adverse events were observed.</p><p><b>CONCLUSIONS</b>Moxifloxacin is effective and safe for treatment of community-acquired pneumonia with aspiration factors. And the regimen of moxifloxacin monotherapy is more convenient compared with levofloxacin plus metronidazole.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Anti-Bacterial Agents , Therapeutic Uses , Community-Acquired Infections , Drug Therapy , Fluoroquinolones , Therapeutic Uses , Levofloxacin , Therapeutic Uses , Metronidazole , Therapeutic Uses , Pneumonia , Drug Therapy , Prospective StudiesABSTRACT
Objective To investigate the diagnostic value of the shear-wave elasticity (SWE) imaging technology on the quantitative diagnosis of chronic nephrosis stage.Methods Sixty patients with nephrosis (nephrosis group) were evaluated with SWE and the renal function test.The Young's modulus value and the renal function were measured,and the results were compared with those of twenty healthy subjects (control group).Results Twenty cases of healthy control group were definited as R0.Sixty patients of nephrosis group were divided into four groups according to renal function:R1-R4.The Young's modulus of the nephrosis group was significantly higher than the control group (P ＜0.01).There were also statistically significant differences among each stage of the nephrosis group (except R1 and R2 of nephrosis group)(P ＜ 0.01).According the ROC curve,the cut-off value of the Young's modulus was 5.53 kPa when maximum area under the curve equal to 0.886,the sensitivity and specificity were 81.70％ and 80.40％.The Young's modulus value and renal function were positively correlated with the stage of nephrosis.The areas under the ROC curves for the Young's modulus,urea nitrogen and csytatin C were 0.965,0.950,0.965 for ≥R3,0.978,0.912,0.961 for =R4,respectively.Conclusions SWE imaging technology provided a new quantitative index for the stage of nephrosis through quantizing the elasticity of the tissue.
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Objective To explore the value of shear wave elastography (SWE) in diffuse thyroid disease.Methods The elastic modulus were detected by SWE in 41cases of diffuse thyroid disease [including 16 cases of Graves' disease (GD),16 cases of Hashimoto' s thyroiditis (HT) and 9 cases of subacute thyroiditis(SAT)] and 30 cases of healthy volunteers.The elastic modulus,including Emean,Emin and Emax,were measured and compared.Results Compared with the normal group[Emean(15.7-± 2.5)kPa,Emin(11.6 ± 2.4)kPa and Emax (20.2 ± 3.0)kPa],the Emean[(20.4 ± 4.7)kPa],Emin[(14.4-± 3.8)kPa] and Emax [(27.8 ± 7.3)kPa] of GD,the Emean [(18.4-± 5.0)kPa] and Emax [(25.2 ± 5.8)kPa] of HT,and the Emean[(11.0 ± 2.9)kPa] and Emin [(6.0 ± 2.7)kPa] of the SAT were different significantly(P =0.001,0.007,0.001 ; P =0.045,0.001 ; P =0.000,0.000).There were significant differences between the SAT and the other two groups,namely GD and HT (P ＜0.05).Such differences,however,were not found between GD and HT (P ＞0.05).Conclusions SWE can be used to measure the elastic modulus of the thyroid tissue quantitatively and objectively,serving as a useful technique to predict the diffuse thyroid disease.
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Objective To observe morphological characteristics and activity distribution of T. asahii biofilm. Methods The morphological characteristics of T. asahii biofilm were observed under an inverted microscope and scanning electron microscope, and activity was measured and quantitatively analyzed by 2,3-bis (2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino) carbonyl]-2H-tetrazo-lium hydroxide (XTT) assay and viable count, respectively. Spatial distribution of dead/vital cells, activity and thickness of biofilm at different layers were assessed under a confocal laser scanning microscope (CLSM) following double staining with FDA/PI. Results T. asahii formed a biofilm in vitro on the surface of polystyrene materials. Under a scanning microscope, the biofilm displayed a complex three-dimensional structure which composed of spores, pseudohy-pha and true hypha. As time prolonged, the activity and quantity of biofilm increased. The results of XTT assay were correlated with those of viable count (r = 0.94, P < 0.01). The activity was of no obvious difference between different layers of the biofilm. The thickness of biofilm varied from 14.3 μm to 31 μm. Conclusions The structure of T. asahii biofilm in vitro is more complex than that of planktonic T. asahii. The activity is of no significant difference between different layers of T. asahii biofilm.
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Objective To study the relationship between ultrasonographic appearance of the endometrium and the blood flow of uterine artery,ovarian stroma and VEGF in the spontaneous ovulating cycle.Methods A total of 30 women with normal ovulating function participated in this study.On the day of positive urinary LH,the subjects were divided into three groups(A,B and C) according to Gonen's criterions of endometrial echogenic patterns.The peak systolic velocity(PSV),end-diastolic velocity(EDV),resistance index(RI) in uterine arteries and ovarian stromal vessels were measured with transvaginal color Doppler ultrasonography;follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E_(2)) and progesterone(P) were assessed by fluoroimmunoassay;and vascular endothelial growth factor(VEGF) was assessed by Enzyme-linked immunosorbent assay on the third day of the cycle,the pre-ovulating phase,and the 6～7 day after ovulation.Results ① During the pre-ovulatory phase uterine arteries and ovarian stromal blood flow PSV in group A was significantly higher than that in group C(P0.05).Conclusion Lower receptivity in the hyperechogenic endometrium may be related with corpus luteum defection and disorder of the uterine blood vessel activities.
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Objective To evaluate the enhancement effect of the thrombus-targeted ultrasound contrast agent on acute thrombus in normal canine femoral vein.Methods Acute thrombi were created in both sides of the femoral vein in ten canine models.Targeted ultrasound contrast agent was given in a dose of(0.06) ml/kg in ten canines via intravenous bolus injection from forelimb of canine,the images of the acute thrombus were taken at 0,2,4,8,12,14 minutes after infusion of ultrasound contrast agent and stored in magneto optical disks.The images were assessed qualitatively by two independent observers and quantitatively using acoustic densitometry(AD) to determine the contrast enhancement effect of acute thrombus in normal canine femoral vein.Results After infusion of targeted ultrasound contrast agent,the thrombus was enhanced considerably and easy to be detected.AD analysis demonstrated that peak indencity(PI) and area under curve(AUC) increased with the changes of time,reaching the peak at 8th minutes after infusion of targeted ultrasound contrast agent,then decreased.PI and AUC increased at the 8th minute after infusion of targeted ultrasound contrast agent than before [((333.21)?(38.56))dB vs((168.18)?(28.18))dB,((884.40)?(94.62))dB vs((439.65)?(98.54))dB,respectively,P
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Objective To explore the creation and control of measurement technique error on digital subtraction angiography (DSA). Methods The data was obtained from Advantx LCV Plus DSA system made by GE Corporation. We divided the screen into three areas, per area account for 1/3, ie, central area, middle area and outlying area. The enlargement rate or reduction rate of the target object was respectively calculated according to the different calibration, different height of the bed and different X-ray source to image distance (SID). Results The target object was enlarged gradually from the central area to the outlying area, and the lengthwise enlargement rate was more obvious than transverse. The different of target object measured by coin (diameter was 20.4 mm) with steel ball (diameter was 7.7 mm) was not significance, but the target object was underestimated significantly used the calibration by 4F catheter. When the target object was measured by the calibration in same area and same axis, the error of measurement technique was controlled rang from 1.0% to-2.5%. Conclusion This systematic investigation suggest that the screen was divided into the central area, middle area and outlying area will be beneficial to control DSA measurement error for the interventional physician. The target object was close to real size when it measured by transverse of the calibration, and the error was better controlled when the calibration was in the same area and same axis as the target object.