ABSTRACT
Objective:To evaluate the etiological diagnosis value of soft bronchoscopy in children with laryngeal stridor.Methods:The clinical data of 402 children with laryngeal stridor wheezing were retrospectively analyzed, which examined by soft bronchoscopy in Anhui Provincial Children′s Hospital from January 2016 to January 2019.Results:A total of 402 cases of laryngeal stridor were diagnosed by soft bronchoscopy, 317(78.8%) cases were diagnosed as congenital airway dysplasia, including 200(49.7%)cases of congenital laryngeal chondromalacia, which including 132 cases of single laryngeal chondromalacia and 68 cases with other respiratory tract dysplasia, and 117(29.1%) cases of respiratory dysplasia other than laryngeal chondromalacia; 46(11.5%) cases of laryngitis; 28(7.0%) cases of airway acquired stenosis and 11 (2.7%)cases of foreign body.Among 402 cases of children with laryngeal stridor who were diagnosed according to clinical feature, combined with chest X-ray, chest CT, CT angiography and color Doppler echocardiography as well as other imaging data, 335(83.3%) cases were congenital laryngeal chondromalacia, 16(4.0%) cases were other respiratory tract dysplasia (including six cases of subglottic and tracheal stenosis, five cases of laryngeal space occupying lesions, four cases of tracheobronchial malformation, and one case of subglottic hemangioma), 35 (8.7%)cases of laryngitis, acquired airway stenosis in 15 cases including 13 cases of congenital heart disease, one case of pulmonary artery sling, one case of mediastinal cyst, and one case of foreign body.Congenital laryngeal chondromalacia, other causes of respiratory dysplasia and foreign body detected by flexible bronchoscopy were not consistent with clinical examination( P<0.05). Conclusion:Congenital laryngeal chondromalacia is the main cause of laryngeal stridor, but it is often associated with other airway dysplasia.Soft bronchoscopy can provides etiological diagnosis for children with laryngeal stridor wheezing, especially in the diagnosis of respiratory tract dysplasia and airway foreign body.
ABSTRACT
@#Myelodysplastic syndrome (MDS) is a group of highly heterogeneous diseases. Anemia is the most common manifestation of MDS, which is also an important factor affecting the survival and quality of life in MDS patients. Different factors are involved in the pathogenesis of anemia of MDS, and for a particular patient, anemia maybe the results of multiple factors. In current review, we summarized the common reasons for MDS anemia including expansion of abnormal clone, immune regulation dysfunction, abnormal hematopoiesis concerning with 5q-, ineffective hematopoiesis and iron overload. Erythropoietin (EPO), immunosuppressive agent, iron chelators, immunomodulatory, transforming growth factor beta (TGF- β) pathway inhibitor, demethylation drugs and hematopoiesis stem cell transplantation may help to improve the anemia of different causes in MDS patients.
ABSTRACT
Objective To investigate the risk of death between older and non-older critical patients in intensive care unit (ICU) in Shuyang People's Hospital.Methods A retrospective cohort study was conducted. The critical patients who aged 15 or above, and admitted to ICU of Shuyang People's Hospital from January 2014 to December 2016 were enrolled, and all the data was collected from theregistration and electronic medical records in the ICU. The prevalence and causes of death in ICU critical patients during the study period were observed. The patients were divided into elderly group (65 years and older) and non-elderly group (15-65 years), and logistic regression analysis was performed for the risk of death in the two groups.Results During the study period, 2707 critical patients in emergency were admitted to the ICU of Shuyang People's Hospital, and patients not satisfied the inclusion criteria were excluded. Finally, a total of 2466 patients were enrolled in the analysis with the male and female ratio of 1.6 : 1, an average age of (61.8±17.3) years, a median Glasgow coma scale (GCS) score of 6 (4, 8), and with a median ICU stay of 3 (1, 6) days. In 2466 critical patients, the most common cause of critical state was spontaneous intracerebral hemorrhage (25.5%) and traumatic brain injury (17.0%), with a fatality rate of 46.0% and 39.5% within first 7 days respectively. Compared with the non-elderly patients (n = 1415), the incidences of death of the elderly patients (n = 1051) due to traumatic brain injury, cerebral infarction, heart failure/cardiovascularcrisis, and respiratory critically ill were significantly increased (9.4% vs. 4.7%, 2.9% vs. 0.8%, 5.0% vs. 2.1%, 2.5% vs. 1.0%, respectively), while the incidence of death for pesticide/drug poisoning in the elderly group was significantly lower than that in the non-elderly group (0.2% vs. 1.2%, allP < 0.01). Stepwise logistic regression analysis showed that traumatic brain injury [hazard ratio (HR) = 1.878, 95% confidence interval (95%CI) = 1.233-2.864,P = 0.003), cerebral infarction (HR = 0.435, 95%CI = 0.229-0.826, P = 0.011), heart failure/cardiovascular crisis (HR = 0.399, 95%CI = 0.238-0.668,P = 0.000), and respiratory critically ill (HR = 0.239, 95%CI = 0.126-0.453,P= 0.000) in the older patients were significantly high risk factors of death as compared with those in non-older patients.Conclusions In the general ICU, the most common cause is spontaneous intracerebral hemorrhage and traumatic brain injury in critical patients with a high fatality rate. The risk of death in elderly patients with severe traumatic brain injury, cerebral infarction, heart failure/cardiovascular crisis, respiratory critically ill is higher than that of the non-elderly patients.
ABSTRACT
According to Charaka Samhita, the disease is the state in which both the body and mind are subject to pain and misery. There is need of classification of disease which is caused by exogenous and endogenous factors. Generally, the classification gives the idea about the type and difference between diseases. Classification of disease is very essential for the treatment of the diseased individual. Unskilled physicians, who are unable to identify nature of disease, examine patient by applying sensory organ which provides only superficial knowledge of disease. To know the whole nature of disease, one should know the classification of disease which is based on origin of disease causative factor, surgical cure or nonsurgical cure, infected organ etc.
ABSTRACT
Objective To explore the causes and clinical features change of acute pancreatitis,to get early diagnosis of severe acute pancreatitis.Methods The clinical data of 1195 cases of patients with acute pancreatitis were retrospectively analyzed.Results Main causes of acute pancreatitis were still biliary disease 31.72％ (379/1195),engorgement 25.44％ (304/1195) and hyperlipidemia 16.82％ (201/1195).But the causes of severe acute pancreatitis had changed.Hyperlipidemia was 44.59％ (140/314),biliary disease accounted for 28.34％ (89/314),engorgement accounted for 17.52％ (55/314).The incidence of hyperlipidemia severe acute pancreatitis was 69.65％ (140/201),the incidence of biliary severe acute pancreatitis was 69.88％ (58/83).The incidence of severe acute pancreatitis on patients with body mass index (BMI) ≤25 kg/m2,BMI26-30 kg/m2,BMI≥31 kg/m2 were 5.41％ (17/314),24.84％ (78/314),69.75％ (219/314).There was significant difference (P ＜ 0.05).The incidence of severe acute pancreatitis on patients at age ≤54 years-old,55-69 years-old,≥70 years-old were 12.42％ (39/314),21.66％(68/314),65.92％ (207/314).There was significant difference (P ＜ 0.05).Conclusions In shanghai,the main causes of acute pancreatitis still is biliary disease and engorgement in the lastest ten years.The causes of severe acute pancreatitis have changed.Hyperlipidemia is main casuse; the second one is biliary disease.The incidence rate of severe acute pancreatitis as well as high BMI and elder age were very high and serious.Thus control of blood-lipid and weight should be strengthened.
ABSTRACT
Objective To explore the causes of deep vein thrombosis in lower extremities (DVT). Meth-ods Retrospective analysis of 411 patients with DVT being treated in our hospital from 2004 to 2009. Results 301 (73.2%) cases were with definite causes and 110( 26.8%) cases without definite causes. 195 cases occurred follow-ing operations and 68 cases following wounds and fractures. 122 cases accompanied with medical conditions ,50 cases occurred following pregnancy or child birth,39 cases suffered from cancer, 19 cases suffered from infection of lower extremity or local lesion,67 cases had past history of DVT. Conclusions Suggest that surgery, wound and fractures, postpartum, cancer, chronic illness inducing long-term bed stay and past history of DVT might correlate with DVT.
ABSTRACT
Objective To analyze the causes of chronic cough. Results Totally 146 patients with chronic cough were diaguosed according to the diagnostic routine based on the guideline on diagnosis and treatment of chronic cough established by Chinese Medical Association, which included medical history, medical examination, X-ray or CT of paranasal sinus or chest, lung function, gastroscope, sputum cytology classification. The final diagnosis was made based on clinical manifestation examination findings and a positive response to therapy. Conclusion The cause of chronic cough was defined in 93.2% of the patients, and multiple causes: Cough variant asthma (n = 45,30.3%), postnasal drip syndrome,PNDs (n = 27, 18.5%), gastroesophageal reflux cough(n = 21,14.4%), post infection cough(n = 16,10.9%), ensinophilic bronchitis(n = 13, 8.9%), drug induced cough(n = 10,6.8%), unidentified cough(n = 10,6.8%). Conclusion Complex etiology of chronic cough,be specific therapeutic effect,and its clear cause is the key to treatment.
ABSTRACT
You ought to differentiate the cause, location, nature and trend of disease, for chronic nephritis. The causes inducing or worsening the disease can be exopathy, as well as internal injury, pathological substance and drug pathogenic factors; while the deficiency of Qi blood Yin Yang of organs is often the internal basis of the disease. The location mainly concerns lung, spleen, liver and kidney, esp. kidney. The nature is deficient root and excessive superficiality; its general trend mostly appears Qi deficiency-both deficiency of Qi and Yin(blood)- both deficiency of Yin and Yang, a discipline of gradual development, and wind, wetness, heat, stasis, sputum and toxin worsen the development of the disease.
ABSTRACT
Based on fundamental theory, literatures of TCM and clinical practice, we have found that there are some errors in the theory of stroke. We put forward several views on it: Firstly, the key reason of stroke is the hidden pathogenic factor which is phlegm and stasis, but not wind and fire. Secondly, the production of wind is due to the liver-blood injury caused by phlegm and stasis; the production of f ire is due to whether the liver-blood injury caused by phlegm and stasis or the f ire stagnated by phlegm and stasis in pericardium. Thirdly, the disease location of stroke is in the level of spirit, not in channels and collaterals. Liver soul injury leads to paralysis and aphemia. Lung soul injury leads to numbness. Kidney will injury leads to sensory aphasia. Pericardium invaded by phlegm and stasis, mind disorder will exists. Fourthly, spirit injury is a def icient syndrome, and supplementing blood and qi is the key of treatment, and expelling phlegm and stasis, balancing yin and yang are also needed. The main treatment principles of liver soul injury, lung soul injury, kidney will injury and pericardium injury are tonifying blood, cultivating qi, replenishing essence and nourishing both qi and blood respectively.
ABSTRACT
In this article,the author analyzes the major causes of diabetes at large.They can be divided into deficiency of yin,weakness of five zang organs,improper diet,intemperance in sexual life,metal stimulation,emotional stress,attack by six climate exopathogens,disoperation by toxin and pathogen,over-taken powder,transformation into dryness and damage to fluids and so on.This article offers some valuable clinical bases for the study of this kind of disease.
ABSTRACT
To explore the characteristics of thought of clinical syndrome differentiation and promote the curative effects in TCM.When treating the patients,doctors must attach great importance to the activities of qi.Only the functional activity of qi theory is studied with the combination of the holistic concept can the curative effects be improved.Perpetual motion theory can not work well without the guidance of holism and visceral theory.The theory of "treatments are determined by the variations of symptoms" which bases itself on the precondition that pathology changes in advance,constitutes one of the treatment methods under the guidance of perpetual motion theory.The word `root' in the theory of "treatment aiming at the root cause of disease" mainly refers to pathogenesis,nature and location of disease,and disease should be analyzed with pathological changes of human body to seek out the root cause of the disease.To accumulate and explore into the treatment by differentiation of syndromes will be conducive to the treatment of the patients who spend long time to cure.The essence of prescription lies in its differentiation in treatment.With the Zhongjing's spirit of prescriptions in mind,though not prescribing in the name of Zhongjing,we can call this kind of prescription is Zhongjing style.Medicine is valued in its quality and character,and also in its wise use under the guidance of TCM theories.
ABSTRACT
Hepatolenticular degeneration,namely Wilson's disease,an autosomal recessive disorder of copper metabolism.The author of this article gave a definition to toxin-pathogen,discussed the basic concept of collaterals disease briefly.And pointed out that hepatolenticular degeneration is a disease due to toxin-pathogen invading collaterals,which was caused by disorder of copper metabolism.This can result in toxin stagnating in collaterals and stagnation of blood stasis in collaterals in the initial stage,and collaterals injured at last.To improve QI-blood circulation and regulate the function of zang fu is important in order to accelerate elimination of toxin and prevent copper from stagnating. Specific therapy vary according to different clinical symptoms,such as promoting blood circulation for removing obstruction in collaterals and clearing toxin, clearing heat-fire and clearing toxin and dispersing stagnated liver-qi for promoting bile flow et al.