ABSTRACT
Objective:To investigate the efficacy of the combined application of fluconazole and sodium bicarbonate in treatment of oral fungal infections among elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).Methods:A total of 360 elderly patients with AECOPD treated in the Emergency Ward of our hospital during July 1, 2018 and December 31, 2019, were included for observation. After admission, the oral mucosal lesions were observed every day, and fungal smear and fungal culture were performed immediately once signs of fungal infection appeared. Meanwhile, fluconazole was given with 300 mg. oral. qd., followed by 150 mg. oral. qd., and 2.5% sodium bicarbonate was given three times a day as gargle.Results:The prevalence of oral fungal infection was 8.3% among which candida infection accounted for 83.2%. The mean treatment time was 5.0 ± 0.3 days. Daily observation of the oral cavity, early detection and application of fluconazole combined with sodium bicarbonate had significantly clinical effect in elderly AECOPD patients with oral fungal infection, with an effective rate of 16.7%, and a cure rate of 83.3%. No toxic side effects on liver and kidney function were found during the treatment. Obvious efficacy was found in relieving clinical symptoms, and there was no increase in hospitalization costs and time.Conclusion:Early combination of fluconazole and sodium bicarbonate has a significant clinical effect on control of oral fungal infection in elderly patients with AECOPD.
ABSTRACT
Objective To investigate the value of ischemia modified albumin (IMA) detection in preliminary diagnosis of acute myocardial infarction (AMI).Methods The levels and variations of IMA,cTnI and CK-MB in 103 patients with acute chest pain were measured continuously at 0,4,6,12,24 hours after admission respectively.Thirty healthy subjects were observed as normal controls.Results Twenty three patients were diagnosed as AMI in the end,the sensitivity and specificity rates right after admission were 89.3％ and91.3％ for IMA,48.4％ and 92.3％ for CK-MB,30.6％ and 93.7％ for cTnI respectively.The sensitivity values at the 6th hours after admission were 91.3％ for IMA,52.2％ for CTnI and 34.8％ for CK-MB respectively.The specificity was 100.0％ when the IMA was detected in combination with CK-MB or cTnI.The sensitivity of co-detection was significantly higher than that any single detection at sixth hours after admission (x2 =15.99,P ＜ 0.01 ).Conclusion Plasma IMA assessment is helpful for early diagnosis of AMI,and will significantly improve the sensitivity early diagnosis of AMI.The co-detection of IMA and CK-MB or cTnI obviously surpasses any single detection,and has extremely vital clinical significance.
ABSTRACT
Objective To discuss the value of ischemia modified albumin (IMA) in the early diagnosis of acute coronary syndrome (ACS). Methods The IMA,cTnI, CK-MB and ECG were detected in 103 patients with suspected ACS (45 cases of NICP and 58 cases of ACS) within 5 hours of acute chest pain onset respectively. 30 healthy subjects were served as normal controls. Receiver operating characteristic (ROC) analysis was used to determine the optimal cutoff of this assay for identifying individuals with ACS from non-ischemic individuals (nonischemic chest pain, NICP). Results of IMA,cTnI,CK-MB and ECG were correlated with the final diagnosis and their diagnostic sensitivities for ACS were evaluated. Results The results suggested that acute phase IMA values between those with ACS and NICP were (89.66 ± 25.82) U/ml, (46.79 ± 17.20) U/ml respectively and showed significant difference. Area under the curve (AUC) of the ROC was 0.935. As the Cut-off point was 71.6 U/ml, the sensitivity, specificity, PPV and NPV of IMA were 90.6%, 71.4% , 82.8% and 83.3%, respectively. The simutanious positive rate of IMA for ischemia origin were 29.3% of cTnI,27.6% of CK-MB and 48.3% of ECG(P＜ 0.01). Conclusions Plasma IMA assessment is valuable for early diagnosis of acute coronary ischemia, and will improve the early diagnostic sensitivity of ACS significantly.