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Objective To observe the clinical effect of Yanshu compound radix sophore injection combined with radiotherapy in treatment of patients with bone metastases from lung cancer. Methods A total of 116 patients with bone metastases from lung cancer admitted to the Department of Radiation Oncology of Gansu Provincial Cancer Hospital from January 2014 to December 2018 were selected. The 58 patients were treated by using three-dimensional conformal radiotherapy (3D-CRT), zoledronic acid and oxycodone sustained-release tablets (control group); the others 58 patients were treated radix sphore injection on basis of control group (integrated Chinese and western medicine). The two groups were treated continuously for 10 days as 1 course of treatment, taking a rest for one week in the middle, then they took the second course of treatment; after the end of 2 courses, the therapeutic effects were evaluated in the two groups. The pain grading, Karnofsky functional status (KPS) score and myelosuppression were observed before and after treatment in two groups, respectively. Results The proportions of patients with painless and mild pain after treatment in the integrated Chinese and western medicine group were significantly lower than those in control group [painless: 22.41% (13/58) vs. 39.66% (23/58), mild pain: 10.35% (6/58) vs. 46.55% (27/58)], while the proportions of patients with moderate pain and severe pain in the integrated Chinese and western medicine group were significantly higher than those of the control group [moderate pain: 53.45(31/58) vs. 12.07% (7/58), severe pain: 13.79% (8/58) vs 1.72% (1/58), both P < 0.05]. After treatment, the proportion of patients with improved KPS score in integrated Chinese and western medicine group was significantly higher than that in control group [55.17% (32/58) vs. 36.21% (21/58), P < 0.05], and the proportion of patients with stable and decreased KPS score were less than that of control group [stable KPS score:18.97%(11/58) vs. 27.59%(16/58), decreased KPS score:25.86% (15/58) vs. 36.21% (21/58)]. The proportions of patients with blood cell count (WBC), hemoglobin (Hb) and platelet count (PLT) showing no myelosuppression (at the zero degree) after treatment in integrated Chinese and western medicine group were obviously higher than those in control group [WBC: 77.59% (45/58) vs. 36.21% (21/58), Hb: 77.59% (45/58) vs. 70.69% (41/58), PLT: 58.62% (34/58) vs. 32.76% (19/58), all P < 0.05]. Conclusion Yanshu compound radix sphore injection combined with radiotherapy can reudce bone metastasis pain, reduce bone marrow suppression and improve quality of life in patients with advanced lung cancer and bone metastasis.
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Fever in patients with severe craniocerebral injury was a frequent occurrence.The rate of fever patients lead to plant man or death high up to 28％-72％.The univariate analysis found that there was significant association between fever and motality.One of the common cause of fever was non-infectious fever,which related with craniocerebral injury,including central fever,dehydration fever,clonus and rebleading fever.The major complication was central high fever after servere craniocerebral injury.The temperature high up to 39 ℃,which aggravated the original basic diseases,lead to respiratory and circulatory failure.Another cause of fever was infection fever which associated with nosocomial infection.Serious disease,long hospiltal stay,high proportion of invasive operation,coma were the high risk factors of patients with craniocerebral injury.The major type of nosocomial infection were pudmonary infection and surgical site infection.By reviewing domestic and foreign literatures and expert consensus,this article was intended to explore the characteristics and mechanism of fever in patients with craniocerebral injury.In order to reduce the secondary brain injury,decrease the disability rate,increase the sutrvival rate,diagnosis and treatment should be taken early.
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Objective To investigate the efficacy of biphasic insulin aspart 50(BIAsp50)twice daily(bid) versusbiphasichumaninsulin50(BHI50)(bid)plusmetforminonbloodglucosecontrolfollowingastandardmealtest in Chinese patients with type 2 diabetes mellitus(T2DM). Methods A randomized, open-label, 2-sequence, crossover trial for two 4-week treatment periods was conducted in 14 Chines institutes. Eligible subjects inadequately controlled with BHI50(bid)plus metformin were randomized to two sequences in a 1 : 1 ratio(A:BIAsp50-BHI50, B:BHI50-BIAsp50 ) . Standard meal tests were performed at baseline and the ends of two periods within 4 weeks. Primary endpoint was 2h postprandial plasma glucose ( PPG) increment following standard meal test, with insulin dose standardized at 0. 3 IU/kg. Results A total of 161 subjects were randomized into two sequences(81 to sequence A, and 80 to sequence B) and finally analysed. After 4 weeks of treatment, mean 2h PPG increment with BIAsp50 was lower than that with BHI50 [ treatment difference of BIAsp50 vs BHI50: -1. 12 mmol/L ( 95% CI-1. 66,-0. 58), P<0. 01], suggesting superiority of BIAsp50 over BHI50. Incremental area under the curve for PPG(0-2 h)with BIAsp50 was lower than that with BHI50 [treatment difference:-38. 8 mmol·L-1·min-1(95%CI-77. 3,-0. 26), P=0. 049], as was the mean 2h PPG [treatment difference:-0. 58 mmol/L(95% CI -1. 13,-0. 03), P=0. 040]. The FPG value with BIAsp50 was higher than that with BHI50 [treatment difference:0. 52 mmol/L(95%CI 0. 18, 0. 86), P=0. 003]. The rate of nocturnal hypoglycemia with BIAsp50 was lower than that with BHI50(1. 13 vs 2. 86 events per subject year, P<0. 01). Conclusion In patients with T2DM inadequately controlled with BHI50 plus metformin, BIAsp50 was proven to be well-tolerated with improved postprandial glucose control compared with BHI50.
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Diabetes complicated with urinary tract infection is influenced by many factors, such as low immune function, high blood and urine glucose environment prone for bacterial growth, and nervous lesion.Diabetic urinary tract infections are characterized by insidious onset, high recurrence rate, correlation with high blood glucose and difficulty to control.The related bacterial pathogens are mainly gram-negative bacillus genus ( 58. 59%-76. 19%) , in which the detection rates of extended spectrum β lactamases( ESBLs) Escherichia coli and Klebsiella pneumonia were the highest, followed by Enterobacter cloacae. Gram-positive bacteria only accounted for 23%. Drug-resistant bacteria and fungi would increase under the condition of repeated infection and irrational usage of antibiotics.In recent years, the urine-derived sepsis caused by urinary tract infection had become a popular clinical research topic because of its concealed symptoms, acute onset, rapid development and high mortality. By reviewing domestic and foreign literatures and expert consensus, this article is intended to explore the characteristics and treatment of diabetic urinary tract infections to supply reference for early prevention, correct diagnosis and effective treatments.
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OBJECTIVE To investigate pathogenic bacteria and prognosis of abdominal infection and take measures to prevent and control it.METHODS We analyzed the clinical material and prognosis of 31 patients with abdominal infection retrospectively according to the culture results of puncture and drain liquid from abdominal cavity from Nov 2007 to Nov 2008.RESULTS In 31 patients,5 were complicated with pulmonary infectionwhich the infection rate was 16.13%,and 7(22.58%) died.Totally 48 pathogenic strains were isolated from ascitic fluid culture,20 strains(41.67%) were Escherichia coli,11 strains(22.92%) were Enterococus.Some of coagulase-negative Staphylococcus,Streptococcus,Candida,Klebsiella pneumoniae,and Staphylococcus aureus were also isolated.The resistance rates of E.coli to cephalosporins were above 50.00%,to quinolones were above 65.00%.The susceptibility rates of E.coli to some ?-lactamases inhibitors and carbapenem were very high.The resistance rate of Enterococus to rifampicin was 63.64%,to piperacillin/tazobactam and piperacillin was 81.82%,to erythromycin was 100.00%.The susceptibility rates of Enterococus to teicoplanin,vancomycin,and linezolid were 100.00%.CONCLUSIONS The predominant pathogenic bacteria of abdominal infection are E.coli and Enterococcus.Abdominal infection tends to combine with pulmonary infection.The patients who got into multiple organ dysfunction syndrome have high mortality.
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OBJECTIVE To enhance the healing rate of the wounded victims in earthquake and to do a good job on the nosocomial infection prevention and control according to the feature of the victims. METHODS The advance medical team on the train evaluated thd traumatic condition of the victims and sorted them according to their condition,then the victims with raw surface infection and that with no wound were arranged to the different sections and wards.The cleaning and medical inspection procedure for the victims were formulated.The secretions of their open wound surface with bacterial,fungal and anaerobic culturing at the very beginning were taken when their traumatic condition were examined.The management of wards,attendants and visitors were strengthened,the hand hygiene compliance and the right way to disposal clinical waste the disinfection and sterilization were supervised and directed. RESULTS Most of the 76 victims were with limbs injury,of which 14 victims with open injury,10 got bacterial or fungal infection.The infection rate was 71.43%.Most of them had got combined infection.No Clostridium tetani and C.perfringens were isolated from the secretion of the raw surface.Three victims were complicated with urinary system infection,1 with pulmonary infection and 1 with bed-sore infection after wounded in earthquake.Basing on effective debridement and change dressings,the antibacterial agents were applied according to pathogenic bacteria and the antimicrobial susceptibility test,so the wound surface and general infection were controled effectivelly.Another 35 victims with closed fracture who were operated with internal fixation and reposition after discection in the limited time were not infected. CONCLUSIONS The infection rate of raw surface of victims with open injury is high.Most of the wound surface are infected with some multidrug resistant bacterial and fungi and combined with urinary system infection or pulmonary infection.The nosocomial infections precaution and control should be strengthened to prevent cross infection when treating the victims wounded in earthquake.
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OBJECTIVE To investigate the status of traumatic infection among earthquake in order to provide reasonable evidence for anti-infective therapy. METHODS Samples were collected from 14 patients with compound fracture or osteofascial compartment syndrome for bacterial,fungal and anaerobic culturing,then according to pathogens to choose antimicrobial susceptibility test (AST). RESULTS Among 14 victims,10 had germ growth in wound secretions,the infection rate was 71.43%. Among 17 samples the bacteria,fungi and anaerobic were isolated in 12,4 and (samples,respectively),the isolated rates were 70.59%,23.53% and 5.89%. The main pathogens for the first culture were Enterobacter cloacae,coagulase negative Staphylococcus (CNS) and Acinetobacter. The Clostridium tetani and C. perfringens were all negative. We also isolated 5 strains of fungi from them 1 strain of Candida. CONCLUSIONS Most of the victims from disaster area have got bacterial infection. Most of them are combined infection,some of the infections are nosocomial infections. The key points of the treatment are to find pathogens immediately and choose a reasonable antibacterial agents according to the AST.
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OBJECTIVE To improve the level of pathogen detection with the software for drug-resistance message input system. METHODS The software which manufactured by the First Affiliated Clinical hospital of General Hospital of PLA,can detect, analyze,calculate and inquire to samples of inpatients. RESULTS The software may classify the drug-resistance with different partner statistic means.Moreover,it can calculate the sample detection rate and positive rate. CONCLUSIONS The software may provide efficiency and effectiveness for drug-resistance detection.
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OBJECTIVE To use the software for hospital infection control in our hospital to improve monitoring of nosocomial infection in invasive nursing procedure and reduce incidence rate of nosocomial infections.METHODS The software for hospital infection control was used in this prospective investigation to collect common information of invasive nursing procedure,institute intervention measure to invasive nursing procedure,and observe the(occurrence) of nosocomial infection.RESULTS Element administration,process administration,and monitoring(administration) were used to real-time control in invasive nursing procedure,thus fasten information transfer and optimize(performance) flow-sheet of nosocomial infections administration.The software usage could accurately(provide) the(information) of nosocomial infection in-time,and feed-back rapidly.CONCLUSIONS Whole process(control) in invasive nursing procedure can discover and solve problems,thus improve efficiency and effectiveness for preventing and controlling nosocomial infection.