ABSTRACT
Objective To analyze the clinical manifestations of refractory mycoplasma pneumoniae pneumonia (RMPP)which unresponded to methylprednisolone in the dosage of 2 mg·kg-1 ·d-1 for 3 day.Methods Retrospective analysis was performed on the clinical data of 120 children with RMPP.The patients were divided into effective group and ineffective group according to ini-tial effeet of 2 mg· kg-1 · d-1 methylprednisolone.The elinical manifestations,laboratory examination,radiological features and bronchofibroscopic findings of the children were compared.Results Twenty-eight patients in 120 were poor curative effect after regular 2 mg·kg-1 ·d-1 methyl prednisolone therapy,accounted for 23.3%.There were 10 patients in 28 with mixed infection,ac-counted for 35.7%;13 patients with appeared necrotizing pneumonia,accounted for 46.4%;13 patients with secretion obstruction, accounted for 46.4%;10 patients with endometrium necrosis,accounted for 35.7%.92 patients in 120 were good curative effect af-ter regular 2 mg·kg-1 ·d-1 methyl prednisolone therapy,accounted for 76.7%.There were 5 patients in 92 with mixed infection, accounted for 5.4%;10 patients with secretion obstruction,accounted for 10.9;5 patients with secretion obstruction,accounted for 5.4%.The difference was statistically significant (P <0.05).There were correlation between effect of hormone therapy and the levels of WBC,N,hs-CRP,LDH,PCT,IL-6,IL-8,LP,SF,D-dimmer.Multiple factors analysis showed that N,hs-CRP,LDH,IL-8, IL-6 were independent risk factors influence the effect of regular hormone therapy (P <0.05).The effective were improved after in-creasing hormone doses or share ivig.Antibiotic use days in effective group was obviously lower than that in ineffective group,.The difference was statistically significant (P <0.05).Duplex control antibiotics use ratio in ineffective group was significantly higher than that in effective group.The difference was statistically significant (P <0.05).Conclusion Treatment with 2 mg·kg-1 ·d-1 methvlprednisolone could improve clinical symptoms and radiological manifestations of most children with RMPP quickly.But it may be ineffective in some situations such as N,hs-CRP,LDH,IL-8 and IL-6.
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Objective:To observe the therapeutic effect of recombinant human brain natriuretic peptide (rhBNP)on patients with cardiorenal syndrome.Methods:The data of 75 patients,who were diagnosed as cardiorenal syndrome and hospitalized in our hospital,were retrospectively analyzed.They were randomly divided into routine treatment group (n=40,received routine treatment)and rhBNP group (n=35,received rhBNP based on routine treatment) according to number table method.The rhBNP was pumped with 0.0075μg·kg-1 ·min-1 using micropump intrave-nously,once/day,about 10h/time and 7d was regarded as a course of treatment.Changes of 24h urine volume,N terminal pro brain natriuretic peptide (NT-proBNP),glomerular filtration rate (GFR)and echocardiograph were recorded in all patients before and 7d after treatment.Results:Compared with routine treatment group after treat-ment,there were significant increase in total effective rate (62.5% vs.94.3%),24h urine volume [(785.2 ± 143.4)ml vs.(965.34±171.8)ml],GFR [(34.1±2.6)ml/min vs.(45.2±5.6)ml/min]and left ventricular e-jection fraction [(35.6±5.5)% vs.(45.9±6.8)%],and significant reduction in NT-proBNP level [(3451.1± 1314.2)pg/ml vs.(1516.43 ± 431.52)pg/ml]in rhBNP group,P<0.01 all.Conclusion:Recombinant human brain natriuretic peptide is safe,effective and can improve renal function in treating patients with cardiorenal syn-drome.
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Objective By discussing the relationship between allergic diseases caused by pollen,pollen density and meteorological factors,making out the warning for the allergic diseases caused by pollen,in order to provide a public service.Methods The data of meteorology from 2001 to 2005 of Tianjin,the pollen monitoring of the Weather Iron Tower Station day by day and the allergic patients whose skin tests were positive in Tianjin Municipal Chest Hospital and Tianjin Municipal Police Hospital were taken to statistical analysis on the rule of seasonal allergic diseases,the relationship between allergic diseases and pollen density and meteorological factors(such as vapor pressure and wind speed),and the prediction equations were obtained for allergic diseases caused by pollen.Results There was obviously positive correlation between the incidence rate of pollinosis(y),weighted pollen density(x11) and vapor pressure(x22) within twenty-days before the onset.The multiple correlation coefficient was 0.805 and the prediction equation was y =2.385+ 0.079 3x11 +3.507x22.Conclusion There is a close correlation between the incidence rate of pollinosis and pollen density.The allergic diseases caused by pollen are also affected by the change of air temperature,varieties of pollen and humidity.